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Congenital Defects & Pediatrics > Defects & Pediatric Perfusion: Topic 2 > Flashcards

Defects & Pediatric Perfusion: Topic 2 Flashcards

1
Q

How old is considered “Neonatal”?

A

<30 days

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2
Q

How old is considered “Pediatric”?

A

Up to 18 yo (<18)

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3
Q

What is the primary energy source for peds?

A

Glucose

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4
Q

What is the primary energy source for adults?

A

Fatty acids

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5
Q

When do neonates myocardium mature?

A

3-12 months

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6
Q

What is immature myocardium prone to?

A

Stretch injury

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7
Q

Weight: <10 kg Volume: ?

A

85 cc/kg

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8
Q

Weight: 11-20 kg Volume: ?

A

80 cc/kg

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9
Q

Weight: 21-30 kg Volume: ?

A

75 cc/kg

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10
Q

Weight: 31-40 kg Volume: ?

A

70 cc/kg

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11
Q

Weight: > 40 kg Volume?

A

65 cc/kg

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12
Q

What weight is considered an adult?

A

>40 kg

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13
Q

What size are Neonatal Packs?

A

3/16’’ x 1/4’’

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14
Q

What size are infant packs?

A

1/4’’ x 1/4’’

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15
Q

What size are pediatric packs?

A

1/4’’ x 3/8’’

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16
Q

What size are small adult packs?

A

3/8’’ x 3/8’’

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17
Q

What size are adult packs?

A

3/8’’ x 1/2’’

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18
Q

Normothermic Flow Weight 0-3 kg

A

200 cc/kg

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19
Q

Normothermic Flow Weight 3-10

A

150 cc/kg

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20
Q

Normothermic Flow Weight 10-15 kg

A

125 cc/kg

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21
Q

Normothermic Flow WEight 15-30 kg

A

100 cc/kg

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22
Q

Normothermic Flow Weight >30 kg

A

75 cc/kg

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23
Q

Normothermic Flow Weight >55 kg

A

65 cc/kg

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24
Q

Some hospitals will index peds flows @ ____m^2 up to ______ m^2

A

2.4 m2 up to 3.2m2

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25
Q

What is the SV/rev in a 3/16’’ boot diameter?

A

7 cc

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26
Q

Do not exceed ______ rpms for max tubing flows?

A

100 rpms

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27
Q

Look for _____ flow- ______ pressure drops.

28
Q

What is the max flow and the prime volume of the Terumo Baby RX05

A

1.5 L/min 43 ccs

29
Q

Basic Prime Constituents: Adults

A

Mannitol NaHCO3 Albumin/Hetastarch Normosol Antibiotic Heparin 10 K units

30
Q

Basic Prime Constituents: Pediatrics

A

Mannitol 25% Albumin CaCl2 Solumedrol Packed RBCs NaHCO3 Normosol Antibiotic Heparin 100 units

31
Q

25% Albumin

A

Large molecule Aids passification of tubing Elevates COP and serum osmolarity Good osmotic “pull” from tissues (1.3:1) Be careful in recommendations

32
Q

What does X-coating call for?

A

Wetting with crystalloid first

33
Q

What antibiotic is titrated during CPB?

A

Vancomycin

34
Q

Name the common antibiotics used on bypass.

A

Cefazolin (Kefzol, Ancef) Ampicillin Gentamicin Nafcillin Vancomycin

35
Q

Cefazolin (Kefzol, Ancef) Dose

A

25 mg/kg (max dose = 1 g)

36
Q

Ampicillin Dose

A

50 mg/kg (max dose = 1g)

37
Q

Gentamicin Dose

A

2 mg/kg (max dose= 80 mg)

38
Q

Nafcillin Dose

A

25 mg/kg (max dose= 1g)

39
Q

Vancomycin Dose

A

10-15 mg/kg (max dose = 1g)

40
Q

Solumedrol (Methylprednisolone) Dose; What two times is it given?

A

30 mg/kg (up to 500mg) in prime and in peds when aoritc xc is released

41
Q

NaHCO3 Prime Concentration

42
Q

How to calculate amt of NaHCO3 necessary for a given amount of asanguinous volume?

A

mEq NaHCO3 = 0.025 (ml asanguinous vol) x = 0.025 V

43
Q

If PRBCs are added to the prime, NaHCO3 dose should be calculated using what formula?

A

mEq NaHCO3 = 0.3 (kg wt) (BE)

44
Q

Mannitol

A

Osmotic Diuretic Elevates Osmolarity rapidly Given over a range of medical disciplines Oxygen radical scavenger

45
Q

Mannitol Dose in the prime; when is it given?

A

0.25 g/ kg in the prime; an additional 0.25 g/kg is administered upon release of the XC

46
Q

Mannitol is what percent solution?

47
Q

What should be measured shortly after the initiation of CPB?

A

Ionized Ca++ level of the perfusate

48
Q

What should ionized Ca++ level of the perfusate be corrected up to? Why?

A

0.7- 0.8 mM/L; this would allow the appropriate level to be present in the cardioplegia solution of a standard 4:1 solution

49
Q

For neonates/infants, how much PRBCs should be added to the prime? Why?

A

Neonates/infants <5kg, 100 ml PRBCs are added to the prime to avoid a prolonged period of asanguinous perfusion

50
Q

Pediatric Monitoring Devices: Common equipment in the pediatric OR

A

ACT TEG Hepcon HMS Platelet Works NIRS CDI Blood gas analyzer

51
Q

What has higher ACT readings: Hemochron or the Hepcon

A

Hemochron has higher ACT readings; hepcon has lower readings

52
Q

TEG

A

Sporatic use in OR/Perfusion Labs Takes a long time to finalize looks at the larger spectrum

53
Q

TEG uses a __________ test on whole blood.

A

Viscoelastic test

54
Q

Viscoelastic

A

Measures both elastic and viscous behavior

55
Q

How often does TEG rotate the specimen in the cuvette?

A

Every 10 seconds

56
Q

Platelet Works

A

Asseses Platelet function and compares functional and non-functional platelets by percentage (%) More useful due to looks at function ,not number

57
Q

NIRS

A

Near-infrared spectroscopy (NIRS), such as that used in pulse oximetry has been used and trusted in the world of medicine for decades Spectroscopic method uses near-infrared region of the electromagnetic spectrum

58
Q

What spectrum does NIRS use?

A

800 nm to 2500 nm

59
Q

CDI In-line Analyzer

A

Standard of care Important in pediatrics pH State or Alpha stat use

60
Q
A

Normal TEG

61
Q
A

Anticoagulants/ Hemophilia TEG

62
Q
A

Platelet Blockers (TEG)

63
Q
A

Fibrinolysis (TEG)

64
Q
A

Hypercoagulation (TEG)

65
Q
A

DIC: Stage 1 (TEG)

66
Q
A

DIC: Stage 2 (TEG)

Congenital Defects & Pediatrics (17 decks)

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