{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T02:52:15Z","timestamp":1775616735619,"version":"3.50.1"},"reference-count":11,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T00:00:00Z","timestamp":1647561600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951122000543_as1\"><jats:title>Background:<\/jats:title><jats:p>As part of a quality improvement project beginning in October 2011, our centre introduced changes to reduce radiation exposure during paediatric cardiac catheterisations. This led to significant initial decreases in radiation to patients. Starting in April 2016, we sought to determine whether these initial reductions were sustained.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122000543_as2\"><jats:title>Methods:<\/jats:title><jats:p>After a 30-day trial period, we implemented (1) weight-based reductions in preset frame rates for fluoroscopy and angiography, (2) increased use of collimators and safety shields, (3) utilisation of stored fluoroscopy and virtual magnification, and (4) hiring of a devoted radiation technician. We collected patient weight (kg), total fluoroscopy time (min), and procedure radiation dosage (cGy-cm2) for cardiac catheterisations between October, 2011 and September, 2019.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122000543_as3\"><jats:title>Results:<\/jats:title><jats:p>A total of 1889 procedures were evaluated (196 pre-intervention, 303 in the post-intervention time period, and 1400 in the long-term group). Fluoroscopy times (18.3 \u00b1 13.6 pre; 19.8 \u00b1 14.1 post; 17.11 \u00b1 15.06 long-term, p = 0.782) were not significantly different between the three groups. Patient mean radiation dose per kilogram decreased significantly after the initial quality improvement intervention (39.7% reduction, p = 0.039) and was sustained over the long term (p = 0.043). Provider radiation exposure was also significantly decreased from the onset of this project through the long-term period (overall decrease of 73%, p &lt; 0.01) despite several changes in the interventional cardiologists who made up the team over this time period.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122000543_as4\"><jats:title>Conclusion:<\/jats:title><jats:p>Introduction of technical and clinical practice changes can result in a significant reduction in radiation exposure for patients and providers in a paediatric cardiac catheterisation laboratory. These reductions can be maintained over the long term.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951122000543","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T10:00:04Z","timestamp":1647597604000},"page":"221-226","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["Sustained radiation reduction following initial quality improvement intervention in a paediatric cardiac catheterisation laboratory"],"prefix":"10.1017","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9845-286X","authenticated-orcid":false,"given":"Anthony","family":"McKeiver","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Churchill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas","family":"Bittel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"James E.","family":"O\u2019Brien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Kaine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Bingler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,3,18]]},"reference":[{"key":"S1047951122000543_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.04.013"},{"key":"S1047951122000543_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951118001257"},{"key":"S1047951122000543_ref2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25467"},{"key":"S1047951122000543_ref8","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.119.008172"},{"key":"S1047951122000543_ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-006-0194-2"},{"key":"S1047951122000543_ref10","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25959"},{"key":"S1047951122000543_ref11","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26024"},{"key":"S1047951122000543_ref5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005425"},{"key":"S1047951122000543_ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-018-2039-9"},{"key":"S1047951122000543_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2010.10.014"},{"key":"S1047951122000543_ref3","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.4466"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951122000543","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T09:48:30Z","timestamp":1684489710000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951122000543\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,18]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["S1047951122000543"],"URL":"https:\/\/doi.org\/10.1017\/s1047951122000543","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,18]]},"assertion":[{"value":"\u00a9 The Author(s), 2022. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}