Inotropes and vasodilators

Cite this article as: Marc Anders. Inotropes and vasodilators, Don't Forget the Bubbles, 2013. Available at: https://doi.org/10.31440/DFTB.3934Vasodilators: Decreasing the pressures against which the heart works (systemic and pulmonary afterload); decreasing the work of the heart hence myocardial O2 demand. Usual indications for vasodilator therapy are: systemic vasodilation (LV afterload reduction), pulmonary vasodilatation (RV afterload reduction),…

Therapeutic hypothermia - ice

Therapeutic hypothermia

Cite this article as: Anna Ings. Therapeutic hypothermia, Don't Forget the Bubbles, 2013. Available at: https://doi.org/10.31440/DFTB.3048 A 4 year old girl presents to ED in cardiac arrest. After a dramatic resus, you and the team were able to bring her back but she remains unconscious.

Haemofiltration and dialysis

Cite this article as: Marc Anders. Haemofiltration and dialysis, Don't Forget the Bubbles, 2013. Available at: https://doi.org/10.31440/DFTB.3735Indications: Correction of water overload To remove larger quantities of water from the body than the kidney is able to achieve in order to enable the administration of therapeutic fluids such as parenteral nutrition To remove excess electrolytes Correction…

Renal Failure

Cite this article as: Marc Anders. Renal Failure, Don't Forget the Bubbles, 2013. Available at: https://doi.org/10.31440/DFTB.3719Definition: acute kidney injury (AKI) is failure of the kidneys to regulate electrolyte, acid-base and fluid homeostasis adequately with concomitant reduction in glomerular filtration rate (GFR). pRIFLE (paediatric Risk, Injury, Failure, Loss, End-Stage Criteria). Chronic renal failure: hyperfiltration, estimated creatinine clearance <75 ml/min/1.73m2 , hypertension,…

Prolonged QT syndrome

Cite this article as: Marc Anders. Prolonged QT syndrome, Don't Forget the Bubbles, 2013. Available at: https://doi.org/10.31440/DFTB.3681Definition: prolonged QTc interval, calculated by Bazett’s formula: QTc = QT : sqr (previous RR interval). normal <440 ms (460 ms in women and children).

Open chest

Cite this article as: Marc Anders. Open chest, Don't Forget the Bubbles, 2013. Available at: https://doi.org/10.31440/DFTB.3705Negative impact on haemodynamics and respiratory parameters after median sternotomy was first described in 1975, with emphasis on “compression of the heart and producing a cardiac tamponade”. Indications for delayed sterna closure and open chest: ‘Large’ heart syndrome Haemodynamic instability…

Nutrition

Cite this article as: Marc Anders. Nutrition, Don't Forget the Bubbles, 2013. Available at: https://doi.org/10.31440/DFTB.3905Facts: 1. Nutritional support for children in PICU is important to prevent deficiency and remain in a positive or neutral neutrogen balance 2. Overfeeding is associated with adverse effects 3. There is no clear evidence supporting PN over TPN 4. If…

Maintenance fluids

Cite this article as: Marc Anders. Maintenance fluids, Don't Forget the Bubbles, 2013. Available at: https://doi.org/10.31440/DFTB.3901Maintenance fluid [ml/hr] requirements for ≤10 kg: Wt / kg 3 5 7 9 10 Active 12 20 28 36 40 Inactive 6 10 14 18 20 Fever add 10 % for every 1 o Celsius Hypothermia deduct 12 % for every…

Fluids

Cite this article as: Marc Anders. Fluids, Don't Forget the Bubbles, 2013. Available at: https://doi.org/10.31440/DFTB.3689Anion gap = Na+ + K+ – (Cl– + HCO3–). normal 8-12 mEq/l. Total body water (TBW) = intracellular fluid (ICF) plus extracellular fluid (ECF). [Weight x 600 ml in adults (500 ml in female), Weight x 650 ml in paeds, Weight x 700 ml in…

Chest drains

Cite this article as: Marc Anders. Chest drains, Don't Forget the Bubbles, 2013. Available at: https://doi.org/10.31440/DFTB.3699If losses >10 ml/kg/hr in a postoperative patient, notify surgeon immediately. In the first two hours, losses may be up to 5 ml/kg/hr, thereafter it should be less than 2 ml/kg/hr. If losses exceeds these levels, check ACT, aPTT, PT,…

Blood products

Cite this article as: Marc Anders. Blood products, Don't Forget the Bubbles, 2013. Available at: https://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…