Chapter 189 - Pediatric vascular trauma Flashcards
Rate of vascular injuries in pediatric patients trauma
0.6%
Unique issues with pediatric vasculature
1) small vessel
2) spasticity of vessel
3) choice for treatment must accommodate growth
Rate of iatrogenic injuries to all pediatric vascular traumas
50%
Most common body part of noniatrogenic vascular injury
Upper extremity
Mortality rate after truncal vascular inury
50%
Rate of overlap of femoral vein and artery
12-33%
Risk factors for serious adverse events in pediatric patient going to cath
1) age < 30 days
2) weight < 2.5 kg
3) larger sheath use (>6F)
Catheter size that cause arterial spasm
1) > 50% of arterial diameter
2) < 1.9 mm smaller than artery
Late complication of pediatric vascular injury
AVF
Vascular spasm being mistaken for injury in pediatrics (rate)
26%
Non-invasive vascular assessment of pediatrics
ABI not reliable until 25 month old or BSA > 0.5 m^2
injured extremity index used instead
Injured extremity index cut off
age over 2: < 0.9
Age under 2: < 0.88
Adjuncts and strategies in pediatric vascular trauma
1) temporary vascular shunts
2) heparin
3) non-operative management of arterial injuries when appropriate
4) fasciotomy early
5) interrupted (for growth) non-absorbable sutures (less thrombogenic)
Rate of access injury in ECMO in pediatric patients
20-52%
routine reconstruction should be done
Management of pulseless pink hand after injury
controversial
Exploration in stable patient and repair should be done
