Peds Test 1

Question 1

Steps to Choosing a Peds Circuit

Answer 1

1) BSA
2) max flow
3) oxygenator
4) boot
5) art line
6) venous line
7) art cannula
8) venous cannula

Question 2

Prime Constituents

Answer 2

25% albumin (increase COP, decrease edema)
**solumerdrol/methylprednisolone- 30 mg/kg- immunosuppressent
**Bicarb- .3 x (kg) x BE
Mannitol .25 g/kg- increase osmolarity/diuretic
CaCl

** add at XC removal

Question 3

3 Diff b/w Peds and Adults

Answer 3

1) Anatomic Difference- myocytes size/strength, mitochondria increase with age, increase SR, Na/K increases with age, after CPB- increase Ca intra, decrease ATP
2) Metabolic Difference- increase O2 demand with age (as they switch from anaerobic to aerobic), Peds use: glucose, carb, fa, aa, ketones Adults use: fa for substrate
Peds can withstand ischemia better cuz more ability with anaerobic
3) Physiologic Difference- prone to hypocalcemia, high effects with hemodilution, high O2 consumption rate (200 mL/kg/min), shunts

Question 4

3 CPG types and dose

Answer 4

1) High/Low K: ID= 30 mL/kg, MD= 15 ml/kg every 15-30 min
- –extracellular, depolarizing-phase 3
2) Custodial (Na): ID= 50 mL/kg, MD 10 mL/kg every 2 hr @ 125 mmHg, 80-90
- –intracellular, hyper polarizing- phase 0
3) Del Nido (1:4): ID= 20 mL/kg, MD= 10ml/kg every 2 hr @ 90-180 mL/min

Question 5

MUF

Answer 5

increase HCT, COP
removes inflammatory mediators, reactive proteins/cytokines, complement activators
bigger pulm effect with IL
–after CPB blood removed by aortic cannula and returned to right atrium @ 20 ml/kg/min max, uses suction to pull off 20-30 ml/min until HCT is 40-50 or 10-20 min