The Ideal Intensive Care Unit for Adults with Congenital Heart Disease

2019 ◽  
pp. 3-14
Author(s):  
David Briston ◽  
Curt Daniels
Keyword(s):  
Intensive Care Unit ◽  
Congenital Heart Disease ◽  
Intensive Care ◽  
Heart Disease ◽  
Congenital Heart ◽  
The Ideal

scholarly journals Penanganan Perioperatif Pasien Penyakit Jantung Kongenital Dewasa dengan ASD, Suspek Hipertensi Pulmonal, LV Smallish

2017 ◽  
Vol 9 (2) ◽  
pp. 71
Author(s):  
Wisnhu Wardhana ◽  
Cindy Elfira Boom
Keyword(s):  
Intensive Care Unit ◽  
Congenital Heart Disease ◽  
Intensive Care ◽  
Heart Disease ◽  
Atrial Septal Defect ◽  
Patent Foramen Ovale ◽  
Congenital Heart ◽  
Septal Defect ◽  
Foramen Ovale ◽  
Asd Closure

Penyakit jantung kongenital dewasa / grown-up congenital heart disease   (GUCH) yang menempati urutan teratas dengan insidensi 10% dari jantung kongenital asianotik pada dewasa adalah atrial septal defect (ASD). Terapi optimal ASD masih kontroversial. Operasi direkomendasikan pada pasien usia pertengahan dan usia tua dengan pintasan kiri ke kanan yang bermakna. Komorbid yang paling sering didapatkan pada defek kongenital pada usia dewasa muda adalah gangguan hemodinamik, hipertensi pulmonal, aritmia,  penyakit kardiovaskular dan penyakit resprasi. Dilaporkan pasien perempuan usia 29 tahun dengan atrial septal defect(ASD) dengan hipertensi pulmonaldan Left Ventricle (LV) Smallishyang dilakukan operasi penututupan defek atrial atau ASD closure. Persiapan preoperasi mencakup anamnesa, pemeriksaan fisik dan pemeriksaan penunjang.Perubahan patologi utama adalah peningkatan resistensi vaskuler paru dan perubahan sekunder terhadap peningkatan aliran darah dari pintasan kiri ke kanan. Masalah yang dihadapi pada pasien  perioperasi ini adalah ukuran jantung kiri baik atrium maupun ventrikel kiri yang kecil memberikan dampak hemodinamik tidak stabil berupa aritmia dan pulmonal hipertensi saat dilakukan penutupan defek. Pemberianobat topangan jantung (nitroglyserin, milrinone, norepinephrine, adrenaline) dan pembuatan Patent Foramen Ovale (PFO) memberikan hasil hemodinamik yang stabil selama operasi dan  di ruang perawatan Intensive Care Unit (ICU).

Use of Emergency-Release, Uncrossmatched O Negative Red Blood Cells (RBCs) in a Tertiary Care Children’s Hospital

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4341-4341
Author(s):  
Jennifer C. Andrews ◽  
Maurene Viele ◽  
Lawrence T Goodnough
Keyword(s):  
Intensive Care Unit ◽  
Congenital Heart Disease ◽  
Intensive Care ◽  
Heart Disease ◽  
Cardiac Catheterization ◽  
Congenital Heart ◽  
Tertiary Care ◽  
Blood Products ◽  
Children's Hospital ◽  
Children’S Hospital

Abstract Abstract 4341 Background: Transfusion services must offer means of issuing blood products quickly for emergent transfusions. At Lucile Packard Children’s Hospital (LPCH), off-site refrigerators were installed in the Neonatal Intensive Care Unit (NICU), the LPCH operating room (OR) and the Cardiovascular Intensive Care Unit (CVICU) inventoried with uncrossmatched O negative RBCs for immediate emergency use. Uncrossmatched O negative RBCs are also provided to children undergoing cardiac catheterization at the discretion of the Pediatric Cardiologist, since these patients commonly do not have type and screen samples drawn until large vessel venous cannulation via insertion of the catheter. Uncrossmatched blood products are also provided for children per our massive transfusion protocol (MTP). The purpose of this study was to assess the utilization of these uncrossmatched blood products in children and its impact on transfusion service (TS) inventory of O negative RBCs. Methods: Orders received for emergency-release uncrossmatched RBCs for patients ages 0 days to 18 years including MTPs from January 1 2011 to March 31 2011 were evaluated retrospectively. Variables collected include: patient demographic information and diagnosis; blood products ordered, released and transfused; location of the patient and location from where blood was dispensed (off-site refrigerator versus [vs] TS). Results: Median patient age was 3.46 years (range 0 days to 15.62 years), and 82% of the patients had congenital heart disease. Sixty four RBCs were issued to 33 patients during the 3-month study period. Of those, 32 RBCs were transfused, 8 RBCs were wasted because temperature parameters were exceeded before return to the TS, and 24 RBCs (38%) were not transfused and returned to TS inventory. Nineteen of the 32 RBCs were transfused, representing 2% of the total 964 O negative RBC units transfused at our institution for that time period. Nineteen (58%) units were for children in the cardiac catheterization suite. Seven patients were in the CVICU, five children were in the NICU, and two were in the Pediatric Intensive Care Unit. Two units of O negative RBCs were dispensed from the emergency off-site refrigerator in the CVICU. Discussion: The majority of children (79%) who received emergency-release uncrossmatched O negative RBCs at LPCH were those with congenital heart disease undergoing cardiac catheterization or being cared for post-operatively in the CVICU. There were 2 instances of children requiring RBCs from off-site refrigerators for an emergent transfusion. Emergency-release, uncrossmatched O negative RBCs at LPCH either from the TS or from three off-site refrigerators caused no undue strain on our supply and inventory of donor O negative RBCs. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Gambaran Penyakit Jantung Bawaan di Neonatal Intensive Care Unit RSUP Prof. Dr. R. D. Kandou Manado Periode 2013 - 2017

e-CliniC ◽  
2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Berry R. Manopo ◽  
Erling D. Kaunang ◽  
Adrian Umboh
Keyword(s):  
Intensive Care Unit ◽  
Congenital Heart Disease ◽  
Intensive Care ◽  
Heart Disease ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Congenital Heart ◽  
Septal Defect ◽  
Clinical Symptoms ◽  
Shortness Of Breath

Abstract: Congenital heart disease (CHD) is a structural heart defect that results from abnormal embryological heart development, or persistence of some parts of the fetal circulation at birth. Congenital heart disease is divided into two categories, namely non-cyanotic congenital heart disease and cyanotic congenital heart disease. Congenital heart disease is caused by interactions between predisposing exogenous factors and endogenous factors. This study was aimed to obtain the profile of CHD in the Neonatal Intensive Care Unit (NICU) of Prof. Dr. R. D. Kandou Hospital Manado in the period 2013 - 2017. This was a retrospective descriptive study using medical record data of patients suffering from CHD in NICU from 2013 to 2017. The results showed that there were 27 patients suffering from CHD consisting of 24 non-cyanotic CHD patients (88.89%) and 3 cyanotic CHD patients (11.11%), and the highest incidence was Atrial Septal Defect (ASD) as many as 17 babies (62.96%). Congenital heart disease was more common in males as many as 18 babies (66.67%). In this study, the clinical symptoms oftenly found was shortness of breath (48.15%) and the most common diagnosis was pneumonia (48.15%). Conclusion: The most common CHD was non-cyanotic CHD. The most commonly found defect was ASD. Clinical symptoms that often arised was shortness of breath, pneumonia was the most common comorbid diagnosis, and the dominant gender of CHD was male.Keywords: non-cyanotic CHD, cyanotic CHD, atrial septal defect Abstrak: Penyakit jantung bawaan (PJB) merupakan defek jantung struktural yang terjadi akibat perkembangan jantung embriologis yang abnormal, atau persistensi dari beberapa bagian dari sirkulasi fetus saat lahir. Penyakit ini dibagi menjadi dua kategori yaitu penyakit jantung bawaan non sianosis dan yang sianosis. Penyakit jantung bawaan disebabkan oleh interaksi antara predisposisi faktor eksogen dan faktor endogen. Penelitian ini bertujuan untuk mendapatkan gambaran penyakit jantung bawaan di Neonatal Intensive Care Unit (NICU) RSUP Prof. Dr. R. D. Kandou Manado periode 2013-2017. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan data rekam medik pasien yang menyandang penyakit jantung bawaan di NICU periode 2013-2017. Hasil penelitian mendapatkan dari 27 pasien dengan PJB, ditemukan PJB non sianotik berjumlah 24 bayi (88,89%) dan PJB sianotik berjumlah 3 bayi (11,11%) dengan angka kejadian terbanyak pada atrial septal defek (ASD) berjumlah 17 bayi (62,96%). Penyakit jantung bawaan paling banyak terjadi pada bayi yang berjenis kelamin laki-laki yaitu berjumlah 18 bayi (66,67%). Gejala klinis yang sering muncul ialah sesak napas (48,15%) dan diagnosis penyerta terbanyak yaitu pnemonia (48,15%). Simpulan: Penyakit jantung bawaan non sianosis merupakan diagnosis terbanyak, jenis ASD, dengan gejala klinis yang sering muncul yaitu sesak napas. Pneumonia merupakan diagnosis penyerta terbanyak. PJB tersering pada jenis kelamin laki-laki.Kata kunci: PJB sianotik, PJB, non sianotik, atrial septal defek

Congenital Heart Disease in the Neonate

2002 ◽  
Vol 21 (3) ◽  
pp. 31-42 ◽  
Author(s):  
Mary Fran Hazinski
Keyword(s):  
Intensive Care Unit ◽  
Congenital Heart Disease ◽  
Intensive Care ◽  
Heart Disease ◽  
Birth Weight ◽  
Neonatal Intensive Care ◽  
Congenital Heart ◽  
Cardiac Development ◽  
Newborn Infants ◽  
Fetal Circulation

Part I: Epidemiology, Cardiac Development, and Fetal CirculationCONGENITAL HEART DISEASE IS PRESENT IN ROUGHLY eight to ten out of every thousand newborn infants.1 However, within the neonatal intensive care unit, the incidence of congenital heart disease is much higher than this, because low birth weight or small-for-date infants are more likely to have congenital heart disease than normal infants.2

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