Myocarditis

Cite this article as:
Anders, M. Myocarditis, Don't Forget the Bubbles, 2013. Available at:
http://doi.org/10.31440/DFTB.3794

See 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 Cardiac enzymes are not elevated in most patients with myocarditis Echo is mandatory to…

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.3790

Modified 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 failure to thrive IV Tachypnea, retractions, grunting or diaphoresis at rest   Causes: Congenital, skeletal myopathy with cardiac involvment (e.g….

ECMO antibiotics

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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 Beta-Lactams: administer 30 – 60min before incision 2nd dose 25mg/kg if operation > 3hrs, continue 25mg/kg 8hrly,…

ECMO

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Anders, M. ECMO, Don't Forget the Bubbles, 2013. Available at:
http://doi.org/10.31440/DFTB.3778

Inclusion 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 >40 on two or more ABG despite maximum therapy [OI = (MAP * FiO2…

Cardiomyopathy

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Anders, M. Cardiomyopathy, Don't Forget the Bubbles, 2013. Available at:
http://doi.org/10.31440/DFTB.3772

Basic 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, caeruloplasmin, transferrin ioforms, pyruvate, selenium, vitamins. Urine: amino acids, organic acids, pligosaccharide screen, MPS…

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.3797

Definition: 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 to transplant or bridge to recovery Standard settings: Driving pressures for Systole and Diastole (Chamber Size /…