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Kathleen Ryan, MD

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Trabajo y educación

Educación

University of Massachusetts Medical School, Worcester, MA, 6/30/2008

Últimos años de residencia

Boston Children's Hospital, Boston, MA, 6/30/2011

Subespecialidad

Boston Children's Hospital, Boston, MA, 6/30/2014

Boston Children's Hospital, Boston, MA, 6/30/2015

Certificado(s) de especialidad

Pediatric Critical Care Medicine, American Board of Pediatrics

Pediatrics, American Board of Pediatrics

Todo Publicaciones

Developments in Pediatric Ventricular Assist Device Support. World journal for pediatric & congenital heart surgery Tume, S. C., Conway, J., Ryan, K. R., Philip, J., Fortkiewicz, J. M., Murray, J. 2019: 2150135119880890

Abstract

Mechanical support devices have revolutionized the management of circulatory failure. This has been met by a dramatic increase in ventricular assist device (VAD) utilization in children over the last two decades. Previous wide gaps in experience and knowledge have significantly narrowed in the recent years. As we continue to gain experience with this technology, we face new challenges such as complex congenital circulations and small patient size. The emergence of new pharmacologic therapies and device technology offers more opportunities and requires constant adjustment in practice. As we continue to embark on this journey, constant insight is needed to refine patient selection criteria, minimize complications, and continue to push the field for safer smaller devices to accommodate these complex patient populations. In this review focused at inpatient critical care environment, we discuss the recent field developments and focus on challenging patient populations, the emergence of temporary support, management of anticoagulation, and diagnostic approach to stroke in the setting of VAD support.

View details for DOI 10.1177/2150135119880890

View details for PubMedID 31663841

Neurodevelopmental Outcomes Among Children With Congenital Heart Disease: At-Risk Populations and Modifiable Risk Factors. World journal for pediatric & congenital heart surgery Ryan, K. R., Jones, M. B., Allen, K. Y., Marino, B. S., Casey, F., Wernovsky, G., Lisanti, A. J. 2019: 2150135119878702

Abstract

As survivable outcomes among patients with complex congenital heart disease (cCHD) have continued to improve over the last several decades, more attention is being dedicated to interventions that impact not just survival but quality of life among patients with cCHD. In particular, patients with cCHD are at risk for impaired neurodevelopmental outcomes. In this review summarizing select presentations given at the 14th Annual Pediatric Cardiac Intensive Care Society's Annual Meeting in 2019, we discuss the neurodevelopmental phenotype of patients with cCHD, patients at greatest risk of impaired development, and three specific modifiable risk factors impacting development.

View details for DOI 10.1177/2150135119878702

View details for PubMedID 31658880

Vasoplegia after pediatric cardiac transplantation in patients supported with a continuous flow ventricular assist device JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY Sacks, L. D., Hollander, S. A., Zhang, Y., Ryan, K. R., Ford, M. A., Maeda, K., Murray, J. M., Almond, C. S., Kwiatkowski, D. M. 2019; 157 (6): 243340
Vasoplegia after pediatric cardiac transplantation in patients supported with a continuous flow ventricular assist device. The Journal of thoracic and cardiovascular surgery Sacks, L. D., Hollander, S. A., Zhang, Y., Ryan, K. R., Ford, M. A., Maeda, K., Murray, J. M., Almond, C. S., Kwiatkowski, D. M. 2019

Abstract

OBJECTIVE: To determine the association between continuous flow ventricular assist devices and the incidence of vasoplegia following orthotopic heart transplant in children. Moreover, to propose a novel clinical definition of vasoplegia for use in pediatric populations.METHODS: This is a single-center, retrospective cohort study set in the cardiovascular intensive care unit of a tertiary children's hospital. All patients aged 3years and older who underwent orthotopic heart transplant at Stanford Universitybetween April 1, 2014, and July 31, 2017, were included. Vasoplegia was defined by the use of vasoconstrictive medication, diastolic hypotension, preserved systolic heart function, and absence of infection or right atrial pressure or central venous pressure <5mm Hg.RESULTS: Of 44 eligible patients, 21 were supported using a continuous flow ventricular assist device. Following heart transplant, 14 patients (32%) developed vasoplegia by the study definition. Development of vasoplegia was associated with pretransplant use of a continuous flow ventricular assist device (52% vs 13%) with a relative risk of 4.02 (95% confidence interval, 1.30-12.45; P=.009). No other variables were predictive of vasoplegia in univariable analysis. Presence of vasoplegia was not associated with adverse outcomes, although there were trends towards higher incidence of acute kidney injury and increased length of hospital stays.CONCLUSIONS: Children receiving continuous flow ventricular assist device support are at increased risk for vasoplegia following orthotopic heart transplant, using a novel definition of vasoplegia. Anticipation of this complication will allow for prompt intervention, thereby minimizing hemodynamic instability and impact on patient outcomes.

View details for PubMedID 30929985

An alternative cannulation approach for venovenous extracorporeal membrane oxygenation in children for long-term ambulatory support. The Journal of thoracic and cardiovascular surgery Maeda, K., Ryan, K., Conrad, C. K., Yarlagadda, V. V. 2018

View details for PubMedID 29685584