Blood products

Cite this article as: Anders, M. Blood products, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3678Pump blood Pump blood is the blood remaining in the bypass circuit on the completion of bypass. It is a mixture of the patient’s own blood, other fluids and any bank blood used to prime the bypass circuit. Unfiltered pump…

Anticoagulation

Cite this article as: Anders, M. Anticoagulation, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3723UNFRACTIONATED HEPARIN (UFH) Indications: Low dose heparin infusions are used in the maintenance of central venous lines, arterial lines and the prevention and treatment of deep vein thromboses. Administration: Heparin can be administered by intravenous and subcutaneous routes. This protocol applies…

Inotropes and vasopressors

Cite this article as: Anders, M. Inotropes and vasopressors, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3876Definition: Inotropes: sympathomimetic agent which act on the sympathetic (or adrenergic) nervous system (β-receptors) resulting in positive inotropic (increase in contractility), chronotropic (increase in heart rate), dromotropic (increase in conduction of impulse) and lusitropic effect (improved diastolic relaxation) Vasopressors: sympathomimetic agent…

Analgesia and sedation

Cite this article as: Anders, M. Analgesia and sedation, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3867Intravenous anaesthetic agents (see table): classified as barbiturates (thiopentone) and non-barbiturates (propofol and ketamine) thiopentone use is largely limited to induction in status epilepticus and for treatment of raised ICP; it has no analgesic properties and is in fact…

Nitric oxide

Cite this article as: Anders, M. Nitric oxide, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3693Definition: nitric oxide (NO) is produced in the endothelium by eNOS (endothelial nitric oxide synthase).

Myocarditis

Cite this article as: Anders, M. Myocarditis, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3794See cardiomyopathy , but cardiac MRI or endomyocardial biopsy to confirm diagnosis Symptoms:  Very nonspecific in children: malaise, fever, poor appetite, tachypnea, tachycardia, chest pain, abdominal pain, myalgia, fatigue, cough, oedema, hepatomegaly, murmur. Investigations: See also cardiomyopathy Nonspecific T changes on ECG…

Heart failure and ventricular assist device (VAD)

Cite this article as: Anders, M. Heart failure and ventricular assist device (VAD), Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3790Modified Ross heart failure classification: Class Symptoms I Asymptomatic II Mild tachypneoa or diaphoresis with feeding. Dyspnea on exertion in older children III Marked tachypnea or diaphoresis with feeding; marked dyspnea on exertion; prolonged feeding time with…

ECMO antibiotics

Cite this article as: Anders, M. ECMO antibiotics, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3783 Indication Prophylaxis Timing Duration ECMO (cannulation, chest revision, reoperation on ECMO, decannulation) – if not on anitbiotics with both gramnegative and grampositive cover already Cephazolin 50mg/kg up to 1g IV or (if cephazolin unavailable)Cephalothin 50mg/kg up to 2g IV Optimal timing for…

ECMO

Cite this article as: Anders, M. ECMO, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3778Inclusion criteria: >34/40 weeks gestation age, reversible cardiac, pulmonary, or cardiopulmonary failure, mechanical ventilation <14 days. Exclusion criteria: Major intracranial haemorrhage, lethal malformation, severe neurological injury, untreatable cardiac or pulmonary malformation. Clinical indications: Failure to wean off cardiopulmonary bypass, oxygenation index…

Cardiomyopathy

Cite this article as: Anders, M. Cardiomyopathy, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3772Basic investigation: ECG, CXR, ECHO, FBE, clotting, UEC  (incl. Ca++, Mg++, Fe++, PO4—), CRP, ESR, albumin, LFT, TFT, BNP, troponin I, troponin T, lactate, ABG, VBG. Extended investigation: Cardiac MRI. 24 hr Holter monitor. Blood: amino acids, carnitine, acyl-carnitine, ammonia, Cu,…

Berlin heart VAD Excor

Cite this article as: Anders, M. Berlin heart VAD Excor, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3797Definition: Paracorporal, pneumatically driven, pulsatile flow mechanical support device driven by a central driving unit (Ikus®) and different sizes of blood pumps (10, 25, 30, 50, 60, 80ml), can be used as RVAD, LVAD or BIVAD. Aim: Bridge…

ABO incompatible blood transfusion

Cite this article as: Anders, M. ABO incompatible blood transfusion, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3786UNOS Policy: ABO incompatible HTX for children up to 2 years (with acceptable isohaemoglutinin titres – less than 1:4) Recipient Donor compatible Donor incompatible Antibodies to avoid Plasma / Platelets RBC 0 0 0 0 AB Anti AAnti B…