Neonatal III Flashcards
What are the CHARGE anomalies?
Coloboma
Heart Anomaly
Atresia (choanal)
Retardation
Genital Anomalies
Ear Anomalies
If a VSD is large, what determines the direction of shunt?
PVR and SVR
Anything that decreases PVR or increases SVR favors a L-to-R shunt
Where is aortic coarctation usually found in neonates?
Usually before the ductus arteriosus
Where is aortic coarctation usually found in the adult?
After the ductus arteriosus
What syndrome is strongly associated with Coarctation of the Aorta?
Turner Syndrome
If a severe coarctation is present, how are the lower extremities perfused?
They have to have a PDA. If the ductus starts to close, they start to have symptoms. We give these patients PGE to keep the ductus patent.
What is the most common single ventricle lesion?
Hypoplastic Left Heart Syndrome
What is a Fontan procedure?
The last of the three surgeries to correct Left Hypoplastic Heart, where the IV is connected to the pulmonary artery via a conduit
If a patient who had a Fontan procedure presents, what kind of anesthetic do they need?
The pulmonary artery flows passively from the IVC, meaning any positive thoracic pressure will stop flow to the lungs. They need to keep breathing spontaneously!
Pierre-Robin Syndrome Airway Effects
Micrognathia
Resp Distress in first 24 hrs
Glossoptosis
Gets easier to manage with age, goes away by age 2
Treacher-Collins
Becomes increasingly difficult with age
Pediatric Ketamine IV induction Dose
1-3 mg/kg
Ketamine IM induction dose
5-10 mg/kg
Ketamine Oral Dose
5-6 mg/kg
Intranasal Versed Dose
0.1-0.2 mg/kg
