***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives : Recent data have suggested an association between the use of dexmedetomidine and a decreased incidence of  acute kidney injury in adult patients after cardiopulmonary bypass . However , no study has focused on this association among pediatric population s where the incidence of acute kidney injury is particularly high and of critical significance . The primary objective of this study was to assess the relationship between the use of postoperative dexmedetomidine and the incidence of acute kidney injury  in pediatric patients undergoing cardiopulmonary bypass . The secondary objective was to determine whether there was an association between dexmedetomidine use and duration of mechanical ventilation or cardiovascular ICU stay . Design : Single-center retrospective matched cohort study . Setting : A 20-bed quaternary cardiovascular ICU in a university-based pediatric hospital in California . Patients : Children less than 18 years old admitted after cardiac surgery with cardiopulmonary bypass between January 1 , 2012 , and May 31 , 2014 . Interventions : None . Measurements and Main Results : Data from a cohort of 102 patients receiving dexmedetomidine during the first postoperative day after cardiac surgery were compared to an age- and procedure-matched cohort not receiving dexmedetomidine . Cohorts had similar baseline and demographic characteristics . Patients receiving dexmedetomidine were less likely to develop acute kidney injury ( 24 % vs 36 % ; odds ratio , 0.54 ; 95 % CI , 0.29–0.99 ; p = 0.046 ) . After adjusting for age , bypass time , nephrotoxin use , and vasoactive inotropic score , the use of dexmedetomidine was associated with a lower incidence of acute kidney injury with adjusted odds ratio of 0.43 ( 95 % CI , 0.27–0.98 ; p = 0.048 ) . There was no difference between the cohorts with respect to the duration of mechanical duration ( 1 d each ; p = 0.98 ) or cardiovascular ICU stays ( 5 vs 6 d ; p = 0.91 ) . Conclusions : The use of a dexmedetomidine infusion in pediatric patients after congenital heart surgery was associated with a decreased incidence of acute kidney injury ; however , it was not associated with changes in clinical outcomes . Further prospect i ve study is necessary to vali date these findings Introduction : Incidence of junctional ectopic tachycardia ( JET ) after repair of tetralogy of Fallot ( TOF ) is 5.6–14 % . Dexmeditomidine is a α-2 adrenoceptor agonist modulates the release of catecholamine , result ing in bradycardia and hypotension . These effects are being explored as a therapeutic option for the prevention of perioperative tachyarrhythmia . We undertook this study to examine possible preventive effects of dexmedetomidine on postoperative JET and its impact on the duration of ventilation time and length of Intensive Care Unit stay . Methods : After obtaining approval from the hospitals ethics committee and written informed consent from parents , this quasi-r and omized trial was initiated . Of 94 patients , 47 patients received dexmedetomidine ( dexmedetomidine group ) and 47 patients did not receive the drug ( control group ) . Results : Dexmedetomidine group had more number of complex variants like TOF with an absent pulmonary valve or pulmonary atresia ( P = 0.041 ) . Hematocrit on cardiopulmonary bypass ( CPB ) , heart rate while coming off from CPB and inotrope score was significantly low in the dexmedetomidine group compared to control group . The incidence of JET was significantly low in dexmedetomidine group ( P = 0.040 ) compared to control group . Conclusions : Dexmedetomidine may have a potential benefit of preventing perioperative JET Objective : The objective of this study was to assess the effectiveness of pre-emptive dexmedetomidine versus amiodarone in preventing junctional ectopic tachycardia ( JET ) in pediatric cardiac surgery . Design : This is a prospect i ve , controlled study . Setting : This study was carried out at a single university hospital . Subjects and Methods : Ninety patients of both sexes , American Society of Anesthesiologists Physical Status II and III , age range from 2 to 18 years , and scheduled for elective cardiac surgery for congenital and acquired heart diseases were selected as the study participants . Interventions : Patients were r and omized into three groups ( 30 each ) . Group I received dexmedetomidine 1 mcg/kg diluted in 100 ml of normal saline intravenously ( IV ) over a period of 20 min , and the infusion was completed 10 min before the induction followed by a 0.5 mcg/kg/h infusion for 72 h postoperative , Group II received amiodarone 5 mg/kg diluted in 100 ml of normal saline IV over a period of 20 min , and the infusion was completed 10 min before the induction followed by a 10–15 mcg/kg/h infusion for 72 h postoperative , and Group III received 100 ml of normal saline IV . Primary outcome was the incidence of postoperative JET . Secondary outcomes included vasoactive-inotropic score , ventilation time ( VT ) , pediatric cardiac care unit stay , hospital length of stay , and perioperative mortality . Measurements and Main Results : The incidence of JET was significantly reduced in Group I and Group II ( P = 0.004 ) compared to Group III . Heart rate while coming off from cardiopulmonary bypass ( CPB ) was significantly low in Group I compared to Group II and Group III ( P = 0.000 ) . Mean VT , mean duration of Intensive Care Unit stay , and length of hospital stay ( day ) were significantly short ( P = 0.000 ) in Group I and Group II compared to Group III ( P = 0.000 ) . Conclusion : Perioperative use of dexmedetomidine and amiodarone is associated with significantly decreased incidence of JET as compared to placebo without significant side effects This study was design ed to evaluate the incidence and risk factors associated with the occurrence of junctional ectopic tachycardia ( JET ) in patients after congenital heart surgery . We prospect ively analyzed cardiac rhythm status in 336 consecutive patients undergoing surgery for congenital heart disease at our institution during a 1-year period . The incidence of JET was 8 % ( 27/336 ) . Repairs with the highest incidence of JET were arterial switch operation ( 3/13 , 23 % ) , atrioventricular ( AV ) canal repair ( 4/19 , 21 % ) , and Norwood repair ( 2/10 , 20 % ) . Compared to patients with no arrhythmias , patients with JET were more likely to be younger ( 2.75 ± 2.44 vs 5.38 ± 7.25 years , p < 0.01 ) , have had longer cardiopulmonary bypass times ( 126 ± 50 vs 85 ± 73 , p < 0.01 ) , and have a higher inotrope score ( 6.26 ± 7.55 vs 2.41 ± 8.11 , p < 0.01 ) . By multivariate analysis , ischemic time was the only factor associated with JET [ odds ratio , 1.01 ( confidence interval , 1.005–1.02 ) ; p = 0.0014 ) . The presence of JET did not correlate with electrolyte abnormalities . JET is not necessarily related to surgery near the His bundle or hypomagnesemia . Longer ischemic time is the best predictor of JET . Patients undergoing arterial switch operation , AV canal repair , and Norwood repair are at highest risk of postoperative JET and should be considered for prophylactic therapy Background : Junctional ectopic tachycardia occurs frequently after congenital cardiac surgery and can be a cause of increased morbidity and mortality . Dexmedetomidine ( DEX ) is an α2 adrenoreceptor agonist , has properties of controlling tachyarrhythmia by regulating the sympatho-adrenal system . Objective : To evaluate the efficacy of DEX for control of junctional ectopic tachycardia after repair of Tetralogy of Fallot ( TOF ) . Material s and Methods : Two hundred and twenty pediatric cardiac patients with TOFs were enrolled in a prospect i ve r and omized control study . Patients underwent correction surgery . They were divided into two groups , i.e. , Group 1 ( DEX ) and Group 2 ( control ) . Heart rate , rhythm , mean arterial pressure ( MAP ) were recorded after the anesthetic induction ( T1 ) , after termination of bypass ( T2 ) , after 04 hours ( T3 ) , and 08 hours after transferring the patient to intensive care unit ( ICU ; T4 ) . Results : Heart rate was comparable between two groups before starting the drug but statistically significant after bypass until 08 hours after transferring the patient to ICU . Junctional ectopic tachycardia occurred more in Group-2 ( 20 % ) as compared to Group-1 ( 9.09 % ; P = 0.022 ) . Junctional ectopic tachycardia occurs early in Group-2 ( 0.14 ± 0.527 hours ) as compared to Group 1 ( 0.31 ± 1.29 hours ; P = 0.042 ) . The duration of junctional ectopic tachycardia was more prolonged in Group-2 ( 1.63 ± 3.64 hours ) as compared to Group-1 ( 0.382 ± 1.60 hours ; P = 0.012 ) . The time to withdraw from mechanical ventilation and ICU stay of Group 1 patient was less than of Group 2 patients ( P = < 0.001 ) . Conclusion : DEX had a therapeutic role in the prevention of junctional ectopic tachycardia in patients undergoing repair for TOF OBJECTIVE Early postoperative arrhythmias are a known complication of cardiac surgery ; however , little data exists specific to pediatrics . The purpose of this study was to determine the incidence and risk factors associated with the development of arrhythmias immediately after surgery in a pediatric population . METHODS Data were collected in a prospect i ve observational format from pediatric patients undergoing cardiac surgery between September 2000 and May 2003 . This format included age , anatomy , surgical repair , and serum magnesium and calcium levels , as well as cardiopulmonary bypass and aortic crossclamp times . Patients were continuously monitored , and hemodynamically significant arrhythmias were recorded . RESULTS Arrhythmias occurred in 28 of the 189 patients enrolled ( 15 % ) including 16 with junctional ectopic tachycardia , 7 with complete atrioventricular block , 4 with ventricular tachycardia , and 1 with re-entrant supraventricular tachycardia . Significant differences were found between the arrhythmia and nonarrhythmia groups with regard to age ( 22 vs 45 months ) , cardiopulmonary bypass time ( 189 vs 109 minutes ) , and aortic crossclamp time ( 105 vs 44 minutes ) ; P < .05 . Magnesium and calcium levels were not significantly different between the groups . Two repairs carried an increased risk : complete atrioventricular septal defect repair , 8 of 11 patients ( 72 % ) , and the arterial switch 5 of 8 patients ( 62.5 % ) ; P < .05 . Atrioventricular septal defects had an even higher incidence when controlled for age , bypass time , and crossclamp time ( odds ratio = 7.65 ) . CONCLUSIONS Hemodynamically significant postoperative arrhythmias are a frequent complication of pediatric cardiac surgery . Younger age and longer bypass and crossclamp times are risk factors for arrhythmia . In addition , the repair of atrioventricular septal defects carries an independent risk of arrhythmias Background : Dexmedetomidine has been reported to have a renal protective effect after adult open heart surgery . The authors hypothesized that intraoperative infusion of dexmedetomidine would attenuate the decrease in renal function after pediatric open heart surgery . Methods : Twenty-nine pediatric patients ( 1–6 years ) scheduled for atrial or ventricular septal defect repair were r and omly assigned to receive either continuous infusion of normal saline ( control group , n = 14 ) or dexmedetomidine ( a bolus dose of 0.5 & mgr;g/kg and then an infusion of 0.5 & mgr;g/kg/h ) ( dexmedetomidine group , n = 15 ) from anesthesia induction to the end of cardiopulmonary bypass . Serum creatinine ( Scr ) was measured before surgery ( T0 ) , 10 minutes after anesthesia induction ( T1 ) , 5 minutes after cardiopulmonary bypass weaning ( T2 ) , 2 hours after T2 ( T3 ) , and after postoperative day 1 ( POD1 ) and postoperative day 2 ( POD2 ) and estimated glomerular filtration rates ( eGFRs ) were calculated . Renal biomarkers were measured at T1 , T2 , and T3 . Acute kidney injury ( 
    Output:
    
The administration of perioperative dexmedetomidine effectively prevents JET in pediatric patients undergoing cardiac surgery but has no significant effect on postoperative renal function .