{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:31:23Z","timestamp":1787776283776,"version":"build-2784847793"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Infants undergoing cardiac surgery are vulnerable to cardiac arrest and subsequent morbidity and mortality. While various risk factors for postoperative cardiac arrest have been identified, no comprehensive framework exists to explain the interrelationships among them. In this study, we first extended Selye\u2019s General Adaptation Syndrome to illustrate the mechanisms leading to postoperative cardiac arrest in this population. We then interviewed 17 expert clinicians to explore infant stress exposure and stress response across the clinical trajectory. Using the qualitative data, we revised and evolved our initial theoretical framework. The evolved theory offers a foundation for future nursing research and clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/ans.0000000000000641","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T21:00:26Z","timestamp":1778619626000},"page":"164-174","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Evolving a Historic Theory to Address a Modern Threat"],"prefix":"10.1097","volume":"49","author":[{"given":"Christine M.","family":"Riley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Pintz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashleigh","family":"Harlow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher W.","family":"Mastropietro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Darcy-Mahoney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quiping (Pearl)","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela S.","family":"Hinds","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"issue":"7","key":"R1-20260826","doi-asserted-by":"crossref","first-page":"e005580","DOI":"10.1161\/CIRCOUTCOMES.119.005580","article-title":"Annual incidence of adult and pediatric in-hospital cardiac arrest in the United States","volume":"12","author":"Holmberg","year":"2019","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"10","key":"R2-20260826","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1097\/PCC.0000000000001273","article-title":"Epidemiology and outcomes of cardiac arrest in pediatric cardiac ICUs","volume":"18","author":"Alten","year":"2017","journal-title":"Pediatr Crit Care Med"},{"issue":"6","key":"R3-20260826","doi-asserted-by":"crossref","first-page":"2138","DOI":"10.1016\/j.athoracsur.2014.06.103","article-title":"Epidemiology and outcomes after in-hospital cardiac arrest after pediatric cardiac surgery","volume":"98","author":"Gupta","year":"2014","journal-title":"Ann Thorac Surg"},{"issue":"12","key":"R4-20260826","doi-asserted-by":"crossref","first-page":"1904","DOI":"10.1016\/j.hlc.2018.11.003","article-title":"Changing risk of in-hospital cardiac arrest in children following cardiac surgery in Victoria, Australia, 2007-2016","volume":"28","author":"Dagan","year":"2019","journal-title":"Heart Lung Circ"},{"issue":"105","key":"R5-20260826","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.resuscitation.2016.04.022","article-title":"Risk factors and outcomes of in-hospital cardiac arrest following pediatric heart operations of varying complexity","author":"Gupta","year":"2016","journal-title":"Resuscitation"},{"issue":"4","key":"R6-20260826","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1097\/MAT.0b013e31825a21ff","article-title":"Pediatric outcomes after extracorporeal membrane oxygenation for cardiac disease and for cardiac arrest: a review","volume":"58","author":"Joffe","year":"2012","journal-title":"ASAIO J"},{"issue":"16","key":"R7-20260826","doi-asserted-by":"crossref","first-page":"e246","DOI":"10.1161\/CIR.0000000000000911","article-title":"P-COSCA (Pediatric Core Outcome Set for Cardiac Arrest) in children: an advisory statement from the International Liaison Committee on Resuscitation","volume":"142","author":"Topjian","year":"2020","journal-title":"Circulation"},{"issue":"96","key":"R8-20260826","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.resuscitation.2015.07.037","article-title":"Long-term evolution after in-hospital cardiac arrest in children: prospective multicenter multinational study","author":"Del Castillo","year":"2015","journal-title":"Resuscitation"},{"issue":"10","key":"R9-20260826","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.3390\/children12101397","article-title":"Quality of life and mental health problems in pediatric cardiac arrest survivors","volume":"12","author":"Schwartz","year":"2025","journal-title":"Children"},{"issue":"1","key":"R10-20260826","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s44253-025-00083-4","article-title":"Understanding infant stress in neonatal and pediatric intensive care: a scoping review","volume":"3","author":"Riley","year":"2025","journal-title":"Intensive Care Med Paediatr Neonatal"},{"issue":"4","key":"R11-20260826","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1177\/21501351221100791","article-title":"Cardiac arrest in children following cardiac surgery: a scoping review of contributing factors","volume":"13","author":"Riley","year":"2022","journal-title":"World J Pediatr Congenit Heart Surg"},{"issue":"4667","key":"R12-20260826","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1136\/bmj.1.4667.1383","article-title":"Stress and the General Adaptation Syndrome","volume":"1","author":"Selye","year":"1950","journal-title":"Br Med J"},{"issue":"July","key":"R13-20260826","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1038\/138032a0","article-title":"Syndrome produced by diverse nocuous agents","volume":"138","author":"Selye","year":"1936","journal-title":"Nature"},{"issue":"18","key":"R14-20260826","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1001\/archinte.1993.00410180039004","article-title":"Stress and the individual. Mechanisms leading to disease","volume":"153","author":"McEwen","year":"1993","journal-title":"Arch Intern Med"},{"issue":"3","key":"R15-20260826","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/0002-9149(70)90796-4","article-title":"The evolution of the stress concept. Stress and cardiovascular disease","volume":"26","author":"Selye","year":"1970","journal-title":"Am J Cardiol"},{"issue":"1","key":"R16-20260826","doi-asserted-by":"crossref","DOI":"10.1001\/jama.300.1.60","article-title":"Epidemiology and treatment of painful procedures in neonates in intensive care units","volume":"300","author":"Carbajal","journal-title":"JAMA"},{"issue":"71","key":"R17-20260826","doi-asserted-by":"crossref","first-page":"e90","DOI":"10.1016\/j.pedn.2023.04.018","article-title":"The relationship between NICU stress and neurodevelopmental outcomes of preterm infants: a multi-center prospective cohort study in China","author":"Xing","year":"2023","journal-title":"J Pediatr Nurs"},{"issue":"5","key":"R19-20260826","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/S0306-4530(03)00091-X","article-title":"The cognitive activation theory of stress","volume":"29","author":"Ursin","year":"2004","journal-title":"Psychoneuroendocrinology"},{"issue":"March","key":"R20-20260826","first-page":"205","article-title":"Allostatic load: a theoretical model for understanding the relationship between maternal posttraumatic stress disorder and adverse birth outcomes","volume":"62","author":"Yang","year":"2018","journal-title":"Midwifery"},{"issue":"3","key":"R21-20260826","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1177\/030631299029003003","article-title":"Putting stress in life: aans selye and the making of stress theory: hans selye and the making of stress theory","volume":"29","author":"Viner","year":"1999","journal-title":"Soc Stud Sci"},{"issue":"4","key":"R22-20260826","doi-asserted-by":"crossref","first-page":"433","DOI":"10.31887\/DCNS.2006.8.4\/mising","article-title":"Genetics of stress response and stress-related disorders","volume":"8","author":"Ising","year":"2006","journal-title":"Dialogues Clin Neurosci"},{"issue":"4","key":"R23-20260826","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S0022-3468(88)80193-3","article-title":"Measuring the severity of surgical stress in newborn infants","volume":"23","author":"Anand","year":"1988","journal-title":"J Pediatr Surg"},{"issue":"9 Suppl","key":"R24-20260826","doi-asserted-by":"crossref","first-page":"S361","DOI":"10.1097\/00003246-199309001-00037","article-title":"Hemodynamic responses to perioperative pain and stress in infants","volume":"21","author":"Wessel","year":"1993","journal-title":"Crit Care Med"},{"issue":"6","key":"R25-20260826","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1177\/0193945909356556","article-title":"Stress and inflammation: a biobehavioral approach for nursing research","volume":"32","author":"Kang","year":"2010","journal-title":"West J Nurs Res"},{"issue":"May","key":"R26-20260826","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.ijsu.2020.07.017","article-title":"Trauma of major surgery: a global problem that is not going away","volume":"81","author":"Dobson","year":"2020","journal-title":"Int J Surg"},{"issue":"2","key":"R27-20260826","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1177\/1099800418824415","article-title":"Allostatic load and biomarkers of stress in the preterm infant: an integrative review","volume":"21","author":"Casavant","year":"2019","journal-title":"Biol Res Nurs"},{"issue":"4","key":"R28-20260826","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/ANC.0000000000000309","article-title":"Infant Medical Trauma in the Neonatal Intensive Care Unit (IMTN): a proposed concept for science and practice","volume":"16","author":"D\u2019Agata","year":"2016","journal-title":"Adv Neonatal Care"},{"issue":"66","key":"R29-20260826","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.pedn.2022.07.008","article-title":"Definitions, theories, and measurement of stress in children","author":"Lynch","year":"2022","journal-title":"J Pediatr Nurs"},{"issue":"2","key":"R31-20260826","doi-asserted-by":"crossref","first-page":"41","DOI":"10.66815\/ajqr\/12973","article-title":"Meaningful member-checking: a structured approach to member-checking","volume":"2023","author":"McKim","year":"2023","journal-title":"Am J Qual Res"},{"issue":"5","key":"R32-20260826","doi-asserted-by":"crossref","first-page":"e0232076","DOI":"10.1371\/journal.pone.0232076","article-title":"A simple method to assess and report thematic saturation in qualitative research","volume":"15","author":"Guest","year":"2020","journal-title":"PLoS One"},{"issue":"4","key":"R33-20260826","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/jjns.12025","article-title":"Energy expenditure in preterm infants during periods of environmental stress in the neonatal intensive care unit","volume":"11","author":"Peng","year":"2014","journal-title":"Jpn J Nurs Sci"},{"issue":"4","key":"R34-20260826","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1260\/0957456001497535","article-title":"New who guidelines for community noise","volume":"31","author":"Berglund","year":"2000","journal-title":"Noise Vib Worldw"},{"issue":"4","key":"R35-20260826","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1542\/peds.100.4.724","article-title":"Noise: a hazard for the fetus and newborn","volume":"100","year":"1997","journal-title":"Pediatrics"},{"issue":"2","key":"R36-20260826","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1017\/S1047951124036163","article-title":"Increased sound levels in the cardiac ICU are associated with an increase in heart rate, blood pressure, and sedation","volume":"35","author":"Caprarola","year":"2025","journal-title":"Cardiol Young"},{"issue":"8","key":"R37-20260826","first-page":"e1137","article-title":"Association between persistent hypothermia after cardiopulmonary bypass in neonates and odds of serious complications","volume":"6","author":"Helman","year":"2024","journal-title":"Crit Care Explor"},{"issue":"5","key":"R38-20260826","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1097\/j.pain.0000000000002125","article-title":"The effect of early procedural pain in preterm infants on the maturation of EEG and heart rate variability","volume":"162","author":"Lavanga","year":"2020","journal-title":"Pain"},{"issue":"6","key":"R39-20260826","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1159\/000351942","article-title":"Measurement of salivary cortisol as a marker of stress in newborns in a neonatal intensive care unit","volume":"79","author":"Cabral","year":"2013","journal-title":"Horm Res Paediatr"},{"issue":"4","key":"R40-20260826","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1097\/PCC.0000000000002892","article-title":"Critical care unit organizational and personnel factors impact cardiac arrest prevention and rescue in the pediatric cardiac population","volume":"23","author":"Lasa","year":"2022","journal-title":"Pediatr Crit Care Med"},{"issue":"4","key":"R41-20260826","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/ANS.0000000000000184","article-title":"The pediatric cardiac intensive care unit parental stress model: refinement using directed content analysis","volume":"40","author":"Lisanti","year":"2017","journal-title":"ANS Adv Nurs Sci"},{"issue":"5","key":"R43-20260826","doi-asserted-by":"crossref","first-page":"e0251255","DOI":"10.1371\/journal.pone.0251255","article-title":"Cerebral oxygen saturation and cerebrovascular instability in newborn infants with congenital heart disease compared to healthy controls","volume":"16","author":"Tran","year":"2021","journal-title":"PLoS One"},{"issue":"3","key":"R44-20260826","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1097\/ANC.0000000000000264","article-title":"Developmental care in North American Pediatric Cardiac Intensive Care Units: survey of current practices","volume":"16","author":"Sood","year":"2016","journal-title":"Adv Neonatal Care"},{"issue":"1","key":"R45-20260826","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1164\/rccm.201604-0708ST","article-title":"A critical care societies collaborative statement: burnout syndrome in critical care health-care professionals. A call for action","volume":"194","author":"Moss","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"issue":"4","key":"R46-20260826","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1017\/S1047951125000599","article-title":"Wake-up call: paediatric cardiac intensive care nurse and advanced practice provider well-being and intent to vacate","volume":"35","author":"Bor","year":"2025","journal-title":"Cardiol Young"},{"issue":"1","key":"R47-20260826","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1186\/s13054-020-2784-z","article-title":"Burnout and Joy in the profession of critical care medicine","volume":"24","author":"Kerlin","year":"2020","journal-title":"Crit Care"},{"issue":"5","key":"R48-20260826","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1097\/NNA.0b013e3181da3f71","article-title":"The relationship of nurse staffing, skill mix, and magnet\u00ae recognition to institutional volume and mortality for congenital heart surgery","volume":"40","author":"Hickey","year":"2010","journal-title":"J Nurs Adm"},{"issue":"9","key":"R49-20260826","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.earlhumdev.2009.05.002","article-title":"Measuring preterm cumulative stressors within the NICU: the neonatal infant stressor scale","volume":"85","author":"Newnham","year":"2009","journal-title":"Early Hum Dev"},{"key":"R50-20260826","doi-asserted-by":"crossref","first-page":"105696","DOI":"10.1016\/j.earlhumdev.2022.105696","article-title":"Quantification of stress exposure in very preterm infants: development of the NeO-stress score","volume":"176","author":"Meesters","year":"2023","journal-title":"Early Hum Dev"},{"key":"R51-20260826","doi-asserted-by":"crossref","first-page":"106146","DOI":"10.1016\/j.earlhumdev.2024.106146","article-title":"Validity and use of the Neonatal Infant Stressor Scale: an integrative review","volume":"199","author":"Nist","year":"2024","journal-title":"Early Hum Dev"}],"container-title":["Advances in Nursing Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/ANS.0000000000000641","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:01:37Z","timestamp":1787774497000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/ANS.0000000000000641"}},"subtitle":["Infant Stress-Mediated Cardiac Arrest Following Cardiac Surgery"],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":48,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/ans.0000000000000641","relation":{},"ISSN":["0161-9268","1550-5014"],"issn-type":[{"value":"0161-9268","type":"print"},{"value":"1550-5014","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-10-30","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-14","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}