Ariya Nu Chau

All Publications

• Abstract 4364013: Virtual Reality Curriculum Improves Pediatric Cardiology Fellow Understanding of Hypoplastic Left Heart Syndrome Palliation: A Multi-Center Study of the Michigan Anatomic Congenital Heart in 3D (MACH-3) Pritz, B., Mccormick, A., Yu, S., Lowery, R., Axelrod, D., Batsis, M., Brown, D., Chau, A., Diab, K., Dove, M., Hahn, E., Handler, S., Lasalle, E., Mille, F., Parra, D., Patel, S., Pierick, A., Romans, R., Salavitabar, A., Werho, D., Wilson, H., Owens, S. LIPPINCOTT WILLIAMS & WILKINS. 2025

  View details for DOI 10.1161/circ.152.suppl_3.4364013

  View details for Web of Science ID 001613910400045

• Favorable Vessel Patency Following Carotid Artery Reconstruction During Extracorporeal Membrane Oxygenation Decannulation in Children With Congenital Heart Disease. World journal for pediatric & congenital heart surgery Chau, A., Maskatia, S. A., Albuliwi, B., Martin, E., Ryan, K. R. 2025: 21501351251338830

  Abstract

  BackgroundCarotid artery ligation has been a common practice after extracorporeal membrane oxygenation (ECMO) decannulation due to the risks of embolization, cerebral infarction, aneurysm, and stenosis over time. Carotid artery reconstruction (CAR) after ECMO decannulation is increasingly used, though studies report variable stenosis rates. Data on CAR in children with heart disease, who may require carotid artery patency for future surgery or repeat ECMO, are lacking.ObjectiveTo evaluate carotid artery patency and the incidence of cerebral infarction in pediatric cardiac patients after CAR and ECMO decannulation.MethodsA retrospective review of children (0-21 years of age) who required venoarterial extracorporeal membrane oxygenation (VA-ECMO) via neck cannulation in the cardiovascular intensive care unit at a quaternary children's hospital (2015-2022) was conducted. Children who underwent CAR and survived to discharge were included.ResultsFifty-three children (ages 2 days to 21 years, median, 2 years of age) met the study criteria. Carotid artery imaging was performed in 25 children (47%), with 84% (21/25) showing unobstructed arteries. Imaging follow-up ranged from two days to four years, with a median of three months. Of 33 children who had post-ECMO head imaging, 11 showed new cerebral infarcts, with 4 of those infarcts diagnosed following transition to ventricular assist device (VAD). Given the variability of timing and modality of head imaging and the significant proportion of patients on a VAD, we are unable to determine the true incidence of new infarcts following CAR.ConclusionCarotid artery reconstruction after VA-ECMO decannulation in children with congenital heart disease shows early favorable vessel patency, but the long-term neurological benefits compared with ligation remain unclear. Further prospective studies are needed to evaluate long-term patency and neurological outcomes.

  View details for DOI 10.1177/21501351251338830

  View details for PubMedID 40405763

• THE COMFORT ZONE: IMPLEMENTATION OF AN ANALGESIA AND SEDATION PROTOCOL IN A PEDIATRIC CVICU Xie, A., Khlifi, K., Chau, A., Kameny, R., Presnell, L., Sandler, B. LIPPINCOTT WILLIAMS & WILKINS. 2025

  View details for DOI 10.1097/01.ccm.0001099484.89341.ef

  View details for Web of Science ID 001411564100034

• Prehospitalization Trauma and Physiologic Factors Associated with the Presence of Post-traumatic Stress 3 Months After PICU Discharge. Journal of intensive care medicine Chau, A. N., Eckberg, R. A., Laksana, E., Ehrlich, L., Ledbetter, D. R., Aczon, M. D., Gold, J. I., Wetzel, R. C., Nelson, L. P. 2024; 39 (3): 268-276

  Abstract

  Children admitted to the pediatric intensive care unit (PICU) have post-traumatic stress (PTS) rates up to 64%, and up to 28% of them meet criteria for PTS disorder (PTSD). We aim to examine whether a prior trauma history and increased physiologic parameters due to a heightened sympathetic response are associated with later PTS. Our hypothesis was children with history of prehospitalization trauma, higher heart rates, blood pressures, cortisol, and extrinsic catecholamine administration during PICU admission are more likely to have PTS after discharge.This is a prospective, observational study of children admitted to the PICU at an urban, quaternary, academic children's hospital. Children aged 8 to 17 years old without developmental delay, severe psychiatric disorder, or traumatic brain injury were included. Children's prehospitalization trauma history was assessed with a semistructured interview. All in-hospital variables were from the electronic medical record. PTS was present if children had 4 of the Diagnostic and Statistical Manual of Mental Disorders IV criteria for PTSD. Student's t- and chi-squared tests were used to compare the presence or absence of prior trauma and all of the PICU-associated variables.Of the 110 children at baseline, 67 had 3-month follow-up. In the latter group, 46% met the criteria for PTS, mean age of 13 years (SD 3), 57% male, a mean PRISM III score of 4.9 (SD 4.3), and intensive care unit length of stay 6.5 days (SD 7.8). There were no statistically significant differences in the demographics of the children with and without PTS. The only variable to show significance was trauma history; children with prehospitalization trauma were more likely to have PTS at 3-month follow-up (P = .02).Prehospitalization trauma history was associated with the presence of PTS after admission to the PICU. This study suggests future studies should shift to the potential predictive benefit of screening children for trauma history upon PICU admission.

  View details for DOI 10.1177/08850666231201786

  View details for PubMedID 38105524

• The end-tidal alveolar dead space fraction for risk stratification during the first week of invasive mechanical ventilation: an observational cohort study. Critical care (London, England) Bhalla, A. K., Chau, A., Khemani, R. G., Newth, C. J. 2023; 27 (1): 54

  Abstract

  BACKGROUND: The end-tidal alveolar dead space fraction (AVDSf=[PaCO2-PETCO2]/PaCO2) is a metric used to estimate alveolar dead space. Higher AVDSf on the first day of mechanical ventilation is associated with mortality and fewer ventilator-free days. It is not clear if AVDSf is associated with length of ventilation in survivors, how AVDSf performs for risk stratification beyond the first day of ventilation, or whether AVDSf adds predictive value to oxygenation (oxygenation index [OI]) or severity of illness (Pediatric Risk of Mortality [PRISM III]) markers.METHODS: Retrospective single-center observational cohort study of children and young adults receiving invasive mechanical ventilation. In those with arterial or capillary blood gases, AVDSf was calculated at the time of every blood gas for the first week of mechanical ventilation.RESULTS: There were 2335 children and young adults (median age 5.8years [IQR 1.2, 13.2]) enrolled with 8004 analyzed AVDSf values. Higher AVDSf was associated with mortality and longer length of ventilation in survivors throughout the first week of ventilation after controlling for OI and PRISM III. Higher OI was not associated with increased mortality until≥48h of ventilation after controlling for AVDSf and PRISM III. When using standardized variables, AVDSf effect estimates were generally higher than OI for mortality, whereas OI effect estimates were generally higher than AVDSf for the length of ventilation in survivors. An AVDSf>0.3 was associated with a higher mortality than an AVDSf<0.2 within each pediatric acute respiratory distress syndrome severity category. The maximum AVDSf within 12h of intensive care unit admission demonstrated good risk stratification for mortality (AUC 0.768 [95% CI 0.732, 0.803]). AVDSf did not improve mortality risk stratification when added to PRISM III but did improve mortality risk stratification when added to the gas exchange components of PRISM III (minimum 12-h PaO2 and maximum 12-h PCO2) (p<0.00001).CONCLUSIONS: AVDSf is associated with mortality and length of ventilation in survivors throughout the first week of invasive mechanical ventilation. Some analyses suggest AVDSf may better stratify mortality risk than OI, whereas OI may better stratify risk for prolonged ventilation in survivors than AVDSf.

  View details for DOI 10.1186/s13054-023-04339-3

  View details for PubMedID 36759925

• Implementation of an Intravenous Fluid Titration Algorithm to Treat Pediatric Diabetic Ketoacidosis. Journal of pediatric intensive care Babbitt, C., Dadios, M., Chau, A., Tse, G., Brown, L., Ladbury, T., Morphew, T., Brakin, M. 2021; 10 (1): 23-30

  Abstract

  Diabetic ketoacidosis (DKA) is a common cause of admission to the pediatric intensive care unit and many centers utilize the "two-bag system" to treat DKA. We developed an intravenous fluid (IVF) titration algorithm to standardize adjustments of the two bags. A retrospective cohort study was performed comparing 155 patients treated before and 175 patients treated after implementation of the IVF titration algorithm. Postimplementation patients reached the blood glucose target zone faster and had a higher probability of remaining at goal while on insulin infusion. There was no significant difference in incidence of cerebral edema or hypoglycemia between study groups. Overall IVF titration algorithm compliance was 95%. Implementation of an IVF titration algorithm is safe and effective when treating DKA in children.

  View details for DOI 10.1055/s-0040-1712921

  View details for PubMedID 33585058

  View details for PubMedCentralID PMC7870333

• Multimodality cardiovascular imaging in the diagnosis and management of prosthetic valve infective endocarditis in children report of two cases and brief review of the literature. Cardiology in the young Chau, A., Renella, P., Arrieta, A. 2019; 29 (12): 1526-1529

  Abstract

  Diagnosing prosthetic valve infective endocarditis in children is challenging. Transthoracic and transesophageal echocardiography can yield false-negative results. Data are lacking in paediatric multimodality imaging in prosthetic valve infective endocarditis. We present two children with repaired CHD where initial echocardiogram was non-diagnostic, while CT angiogram and 18F-fluorodeoxyglucose positron emission tomography in combination with CT angiography, respectively, confirmed the diagnosis of endocarditis affecting clinical management.

  View details for DOI 10.1017/S1047951119002233

  View details for PubMedID 31590699