Flashcards in Peds II Part I Deck (109)
What is considered an ex premature infant?
<37 weeks and <60 weeks postconceptional age
How long should expremature patients be monitored after general surgery?
12-24 hours for apnea and O2 desaturation
what are the factors that increase risk of periop apnea
< 60 weeks postconceptual
anemia <12 gm Hgb
secondary diagnoses (intraventricular hemorrhage)
should you avoid opioids in expremature infants in genral?
what caffeine dose can be used to decrease the frequency of apnea in expremature infants?
when can an expremature infant be discharged after general?
12 hrs free of apnea
does regional increase risk of periop apnea?
what valve is involved in Ebstein's anomaly?
what portions of the tricuspid valve leaflets are displaced into the RV?
septal and posterior
is the anterior valve leaflet of the Tricuspid abnormal in Ebsteins anomaly?
describe the anterior valve of the tricuspid in Ebsteins anomaly
elongated and sail like with chordal attachments to the RV free wall
is there an RV outflow tract obstruction in ebsteins?
is the tricuspid valve regurgitant or stenotic in ebsteins?
usually regurgitant (may be stenotic)
what type of interatrial communication is present in ebsteins?
R to L shunting
what happens to the RA in Ebsteins?
what happens to the RV in Ebsteins?
atrialized and reduced cavity
neonatal clinical presentation of Ebsteins
systemic venous congestion
worsens after ductus arteriosis closes
older children clinical presentation of Ebsteins
adolescent and adult presentation of Ebsteins
SVT to CHF
what are the risks for Ebsteins?
What are the signs and symptoms of Ebsteins anomaly? (thats right...there is more)
cyanosis (depends on R to L shunt)
systolic murmur (left lower sternal border)
tall broad P waves, 1st degree block
PST and VT
treatment options of ebsteins
tricuspid valve repair to fontan procedure to transplant
associated complications after Ebsteins anomaly repair
what are the surgical goals of Ebstein anomaly repair?
repair or replace tricuspid valve
repair atrial defect
complications after ebsteins anomaly repair
3rd degree AV block
residual tricuspid regurg
prosthetic valve dysfunction
is the effect of IV anesthetics effected in Ebsteins?
yes; usually delayed effect of IV anesthetics
what are the major anesthetic hazards associated with ebsteins?
depressed RV function
increases in R to L shunt
Other goals of anesthetic management of Ebsteins
minimize mechanical metabolic affects of ventilation
maintain RV contractility
3 most common cardiac anomalies related to trisomy 21
complete atrioventricular canal defect (40%)
ventricular septal defect (25%)
atrial septal defect (10-15%)