The Effect of Diagnostic Blood Loss on Anemia and Transfusion Among Postoperative Patients With Congenital Heart Disease in a Pediatric Intensive Care Unit

2018 ◽  
Vol 38 ◽  
pp. 62-67 ◽  
Author(s):  
Dan Zhou ◽  
Yu-Lan Luo ◽  
Shu-Hua Luo ◽  
Mei Feng ◽  
Meng-Lin Tang
Keyword(s):  
Intensive Care Unit ◽  
Congenital Heart Disease ◽  
Intensive Care ◽  
Heart Disease ◽  
Blood Loss ◽  
Pediatric Intensive Care Unit ◽  
Congenital Heart ◽  
Pediatric Intensive Care

Propofol Anesthesia for Elective Cardioversion of, Pediatric Intensive Care Unit Patients with Congenital Heart Disease

1997 ◽  
Vol 12 (5) ◽  
pp. 264-268 ◽  
Author(s):  
James H. Hertzog ◽  
Joyce K. Campbell ◽  
Heidi J. Dalton ◽  
John T. Cockerham ◽  
Gabriel J. Hauser
Keyword(s):  
Intensive Care Unit ◽  
Congenital Heart Disease ◽  
Intensive Care ◽  
Heart Disease ◽  
Length Of Stay ◽  
Pediatric Intensive Care Unit ◽  
Recovery Time ◽  
Congenital Heart ◽  
Pediatric Intensive Care ◽  
Direct Current Cardioversion

Propofol is an intravenous sedative-hypnotic anesthetic agent that has been increasingly employed to facilitate elective direct current cardioversion in adult patients. Little information is available about use of propofol in pediatric intensive care unit patients with congenital heart disease undergoing elective cardioversion. We report our experience with 33 cardioversions performed in our pediatric intensive care unit using propofol anesthesia. Propofol provided good subjective conditions for cardioversion in all patients, and 97% of cardioversions successfully converted atrial flutter into a sinus rhythm. Mean induction time was 5.97 ± 3.54 minutes, and recovery time was 28.08 ± 22.88 minutes. Length of stay in the pediatric intensive care unit was 3.84 ± 1.20 hours. Transient hypotension occurred during 24% of cardioversions, whereas brief periods of respiratory depression were present during 30% of cardioversions. Propofol anesthesia can be successfully administered during elective cardioversion in pediatric intensive care unit patients with congenital heart disease provided that appropriate cardiorespiratory monitoring and supportive therapies are in place.

scholarly journals Experience of parents of children with congenital heart disease: feelings and obstacles

Rev Rene ◽  
2016 ◽  
Vol 17 (1) ◽  
pp. 128 ◽  
Author(s):  
Thaís Sena Mombach Barreto ◽  
Victória Tiyoko Moraes Sakamoto ◽  
Jardel Scremin Magagnin ◽  
Débora Fernandes Coelho ◽  
Roberta Waterkemper ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Congenital Heart Disease ◽  
Intensive Care ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pediatric Intensive Care ◽  
Thematic Content Analysis ◽  
Network Support ◽  
Reference Hospital ◽  
Interdisciplinary Network

Understand the meaning of the experiences of parents of children with congenital heart disease regarding feelings, obstacles and expectations. Methods: exploratory qualitative study conducted at a pediatric intensive care unit of a reference hospital. Participants corresponded to seven mothers and four fathers of children with congenital heart defect, surgically corrected and with more than 8 hours of admission, totalling 11 participants.  Data collection was performed through semi-structured individual recorded interviews. Data were described according to thematic content analysis. Results: five thematic categories emerged: (1) unpreparedness to face the problem; (2) feelings involved (3) factors that make difficult to face the problem; (4) factors that facilitate facing the problem; (5) spirituality. Conclusion: each family is unique and needs support to better face the disease and its process. It is essential to develop interdisciplinary network support, providing comprehensive care.

Cardiac Arrest in Infants After Congenital Heart Surgery

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
John F. Rhodes ◽  
Andrew D. Blaufox ◽  
Howard S. Seiden ◽  
Jeremy D. Asnes ◽  
Ronda P. Gross ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Pediatric Intensive Care ◽  
Congenital Heart Surgery ◽  
Inotropic Support

Background —The survival rate to discharge after a cardiac arrest in a patient in the pediatric intensive care unit is reported to be as low as 7%. The survival rates and markers for survival strictly regarding infants with cardiac arrest after congenital heart surgery are unknown. Methods and Results —Infants in our pediatric cardiac intensive care unit database were identified who had a postoperative cardiac arrest between January 1994 and June 1998. Parameters from the perioperative, prearrest, and resuscitation periods were analyzed for these patients. Comparisons were made between survivors and nonsurvivors. Of 575 infants who underwent congenital heart surgery, 34 (6%) sustained a documented cardiac arrest; of these, 14 (41%) survived to discharge. Perioperative parameters, ventricular physiology, and primary rhythm at the time of arrest did not influence outcome. Prearrest blood pressure was lower in nonsurvivors than in survivors ( P <0.001). A high level of inotropic support prearrest was associated with death ( P =0.06). Survivors had a shorter duration of resuscitation ( P <0.001) and higher minimal arterial pH ( P <0.02) and received a smaller total dose of medication during the resuscitation. Although survivors had an overall shorter duration of resuscitation, 5 of 22 patients (23%) survived to discharge despite resuscitation of >30 minutes. Conclusions —The outcome of cardiac arrest in infants after congenital heart surgery was better than that for pediatric intensive care unit populations as a whole. Univentricular physiology did not increase the risk of death after cardiac arrest. Infants with more hemodynamic compromise before the arrest as demonstrated with lower mean arterial blood pressure and higher inotropic support were less likely to survive. The use of predetermined resuscitation end points in this subpopulation may not be justified.

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.

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