We’re back with thirteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.
These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points.
Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".
Host: Em Gootee
Bellía-Munzón G, Sanjurjo D, Toselli L, Vallee M, Elmo G, Martínez-Ferro M. Novel index to estimate the cephalocaudal extent of the excavation in pectus excavatum: The Titanic index. J Pediatr Surg. 2023 Apr;58(4):605-607. doi: 10.1016/j.jpedsurg.2022.12.010. Epub 2022 Dec 23. PMID: 36681535.
https://www.jpedsurg.org/article/S0022-3468(22)00783-7/fulltext
Namachivayam SP, Law S, Millar J, d'Udekem Y. Early Peritoneal Dialysis and Postoperative Outcomes in Infants After Pediatric Cardiac Surgery: A Systematic Review and Meta-Analysis. Pediatr Crit Care Med. 2022 Oct 1;23(10):793-800. doi: 10.1097/PCC.0000000000003024. Epub 2022 Jul 15. PMID: 35839279.
https://pubmed.ncbi.nlm.nih.gov/35839279/
Scalise PN, Durgin JM, Staffa SJ, Wynne N, Meisner J, Ngo P, Zendejas B, Kim HB, Demehri FR. Pediatric button battery ingestion: A single center experience and risk score to predict severe outcomes. J Pediatr Surg. 2023 Apr;58(4):613-618. doi: 10.1016/j.jpedsurg.2022.12.017. Epub 2022 Dec 22. PMID: 36646540.
https://www.jpedsurg.org/article/S0022-3468(22)00790-4/fulltext
Type: video · 4 min · posted 2023-11-13 Canonical: https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638 ## Chapters - [0:09](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=9) Introduction and Paper Overview - [0:54](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=54) Titanic Index for Pectus Excavatum - [2:08](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=128) Early Peritoneal Dialysis After Cardiac Surgery - [2:59](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=179) Button Battery Ingestion Risk Score ## Statements - "The Haller index and correction index are currently the primary indices used for pectus excavatum and tell us about the severity of the deformity" — Ellen Encisco (clinical) [1:12](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=72) - "The Titanic index is the percentage of the sternum that lies behind the anterior costal line as seen on CT scans" — Ellen Encisco (clinical) [1:26](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=86) - "There is a weak correlation between the Titanic index and the other indices (Haller and correction indices)" — Ellen Encisco (clinical) [1:44](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=104) - "The Titanic index might be more helpful for determining how many bars a patient will need for pectus excavatum repair" — Ellen Encisco (clinical) [1:44](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=104) - "A Titanic index threshold of 66.5% was established, with patients above this threshold probably needing more than 2 bars for repair" — Ellen Encisco (clinical) [1:55](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=115) - "The meta-analysis included 5 studies on early peritoneal dialysis after pediatric cardiac surgery" — Alex Halpern (epidemiological) [2:32](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=152) - "Early initiation of peritoneal dialysis was associated with decreased post-operative mortality in infants after cardiac surgery" — Alex Halpern (clinical) [2:35](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=155) - "Early initiation of peritoneal dialysis shortened duration of mechanical ventilation after pediatric cardiac surgery" — Alex Halpern (clinical) [2:41](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=161) - "Early initiation of peritoneal dialysis shortened length of stay in the ICU after pediatric cardiac surgery" — Alex Halpern (clinical) [2:41](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=161) - "The button battery study was a retrospective study done at Boston Children's Hospital from 2008 to 2021" — Cecilia Gigena (epidemiological) [3:16](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=196) - "The button battery study analyzed 143 patients, of whom 24 had severe outcomes" — Cecilia Gigena (epidemiological) [3:30](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=210) - "Location of the button battery in the esophagus is an independent predictor for severe outcomes" — Cecilia Gigena (clinical) [3:37](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=217) - "A button battery larger than 2 centimeters is an independent predictor for severe outcomes" — Cecilia Gigena (clinical) [3:45](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=225) - "Having symptoms at presentation is an independent predictor for severe outcomes in button battery ingestion" — Cecilia Gigena (clinical) [3:49](https://library.globalcastmd.com/watch/quick-literature-updates-episode-13-7638?t=229) ## Transcript Hello pediatric surgery family, I'm E Gdy, a research fellow from Cincinnati Children's Hospital Medical Center. And today our team is going to deliver the articles that you should know about. We have 3 papers today. 2 of them are from the Journal of Pediatric Surgery, and the 1 in the middle is from pediatric Critical care medicine. We don't have much time, so let's start. Our first paper titled Navel Index to Estimate the cephalocaudal extent of the excavation in Pus excavatum. The Titanic index by Bello Monson et al. This paper is summarized by Ellen and Cisco. She was a research fellow at Cincinnati Children's, and as of July she is back to being a general surgery resident at Mayo Clinic. In this article, the authors introduced a new index for patients with pectus excavatum. The indices that are currently primarily used are the Haller index and the correction index, and they tell us about the severity of the deformity. This new index, or the Titanic index as they're calling it, takes into account the extent of the deformity. Essentially, it's the percentage of the sternum that lies behind the anterior costal line as seen on CT scans. So the authors did a retrospective review of patients at their institution in Argentina who had undergone minimally invasive repair of pectus excavatum. And calculated all these indices. They found a weak correlation between the Titanic index and the other indices, but also they found the Titanic index might be more helpful for helping determine how many bars a patient's going to need for repair. The threshold they established here was 66.5%, meaning that patients with a higher titanic index than that probably needed more than 2 bars. Awesome. Our second paper is Early Peritoneal Dialysis and Postoperative Outcomes in Infants after Pediatric cardiac Surgery, a Systematic Review and meta-analysis by Namachi YM et al. And this paper summarized by Alex Halpern. He's one of our contributors here at Staker and MD and a general surgery resident at George Washington University. They ended up including 5 studies in their meta-analysis. They found that early initiation of peritoneal dialysis was associated with a decreased post-op mortality. They also found that early initiation of peritoneal dialysis shortened duration of mechanical ventilation and shortened length of stay in the ICU. So it seems that early initiation of peritoneal dialysis may benefit infants after pediatric cardiac surgery. Now moving to the last paper of the day, pediatric button better ingestion, a single center experience and risk score to predict severe outcomes by Skillies at all. This one is summarized by Cecilia Jhena. She's a research fellow at Cincinnati Children's. This is a retrospective study done in Boston Children's Hospital from 2008 to 2021, and their aim was to propose a risk score to predict severe outcomes in patients with a bottom buttery intestine. They analyzed 143 patients. Of them, 24 had severe outcomes, and they found. Three independent predictors for severe outcomes. The first was the location of the bottom battery in the esophagus. Second, a bottom battery larger than 2 centimeters. And third, having symptoms at presentation. Thank you for listening. Please check the link in the description below to read each paper. We hope you liked this episode. Please follow Stay Current MD on social media. Give us a rating, and subscribe to the YouTube channel. And don't forget to download the Stay Current app on the App Store or Play Store for tons of content. --- Not medical advice · citation policy: https://library.globalcastmd.com/ai