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Peds > Test 1 Hypothermia > Flashcards

Test 1 Hypothermia Flashcards

0
Q

Cause for increased myocardial oxygen demands

A

Switch from anaerobic to aerobic metabolism

Because immature myocardium can rely more on anaerobic metabolism can withstand ischemic injury better

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1
Q

Calcium handling in Peds

A

Immature myocardium increased Intracellular concentration post ischemia/reperfusion
This activates and lowers stores of ATP, contributing to dysfunction

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2
Q

Flow rate required due to high oxygen consumption rates in infants

A

Up to 200ml/kg/min

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3
Q

Glucose in adults vs Peds

A

Adults: hyperglycemia
Peds: hypoglycemia

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4
Q

4 events that trigger stress

A

Ischemia
Hypothermia
Anesthesia
Surgery

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5
Q

CPB causes release of

A 
Cathecholamines
Cortisol
ACTH
TSH
Endorphins
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6
Q

Normal urine output for adults

A

.5-1 ml/min

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7
Q

Normal urine output for Peds

A

1ml/kg/hr

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8
Q

Core temperature monitoring in Peds

A 
Bladder
Nasopharyngeal
Tympanic
Esophageal 
Venous
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9
Q

Shell (peripheral) temperature monitoring in Peds

A

Rectal

Skin

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10
Q

“Safe” period durations of DHCA

A

> 32C: <18C: 45-60min

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11
Q

Cannulation Used for DHCA if heart is NOT opened until circulatory arrest

A

Single aortic cannula

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12
Q

Cannulation used if heart is opened BEFORE circulatory arrest

A

Bicaval cannulation

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13
Q

Pressure maintained in SVC during retrograde cerebral perfusion

A

15-20mmHg

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14
Q

Antegrade cerebral perfusion

A

Use open end of Blalock Taussig shunt after proximal anastamosis is constructed

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15
Q

Flow for antegrade cerebral perfusion

A

10-20ml/kg/min
OR pressure of 40-50mmHg in right radial artery
Neonates: 30-40ml/kg/min

16
Q

Complications to antegrade cerebral perfusion

A 
Dissection of arterial wall
Air
Atheromatous plaque embolization
Malposition of cannula
Overcrowding of operative field
17
Q

Affects of pH stat

A 
Temperature corrected
Higher pCO2 (respiratory acidosis) 
Increased cerebral blood flow
Add CO2 to maintain pCO2 of 40
When blood warmed to room temp, is acidotic and hypercapnic
18
Q

3 infant cerebral oximeters

A

INVOS
NONIN EQUINOX
FORE-SIGHT

Peds (13 decks)

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