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…

Central venous catheters

Cite this article as: Anders, M. Central venous catheters, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3767Use of central venous catheters in the acute care setting is an integral approach to deliver fluids, blood products, nutrients, medications, obtaining blood specimens, maintaining emergency vascular access, and for haemodynamic monitoring. Risk factors: Mechanical complications (malposition, occlusion, dislodgement,…

Infection

Cite this article as: Anders, M. Infection, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3764Surgical site infection (superficial/deep/organ): Prevalence 5-10% Within 10-14 days post surgery Most common: Staphylococcus aureus Risk factors: neonate, HLHS, hospitalization prior surgery, TPN, emergency procedures, long CPB Blood stream infection: Prevalence 5-10% Within 10-14 days post surgery Most common: gram negative…

Formulae

Cite this article as: Anders, M. Formulae, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3746Body surface index (BSA) = ( [Height(cm) x Weight(kg) ] / 3600 )½ Mean arterial blood pressure (MAP) = (SBP + 2 x DBP) / 3 Transpulmonary gradient (TPG) = mPAP – PCWP or in Glenn/Fontan: SVC (CVP) – LAP Cardiac output (CO) = SV x…