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Cardiovascular Pediatric Critical Illness and Injury

:	Derek S. Wheeler, Hector R. Wong, Thomas P. Shanley
:	Derek S. Wheeler, Hector R. Wong, Thomas P. Shanley
:	Cardiovascular Pediatric Critical Illness and Injury
:	Springer-Verlag
:	9781848009233
:	1
:	CHF 47.50
:

:	Klinische Fächer
:	English

:	294
:	Wasserzeichen
:	PC/MAC/eReader/Tablet
:	PDF

The development of pediatric cardiac surgical programs has had a profound effect on the s- cialty of pediatric critical care medicine, and as a result, the ? eld of pediatric cardiac intensive care is rapidly emerging as a separate subspecialty of pediatric critical care medicine. The ability to provide care for the critically ill child with congenital heart disease clearly separates pediatric intensivists from our adult colleagues. A thorough understanding and knowledge of the unique physiology of the child with congenital heart disease are therefore absolutely crucial for anyone working in the pediatric intensive care unit. Once again, we would like to dedicate this textbook to our families and to the physicians and nurses who provide steadfast care every day in pe- atric intensive care units across the globe. Derek S. Wheeler Hector R. Wong Thomas P. Shanley v Preface to Pediatric Critical Care Medicine: Basic Science and Clinical Evidence The ? eld of critical care medicine is growing at a tremendous pace, and tremendous advances in the understanding of critical illness have been realized in the last decade. My family has directly bene? ted from some of the technological and scienti? c advances made in the care of critically ill children. My son Ryan was born during my third year of medical school. By some peculiar happenstance, I was nearing completion of a 4-week rotation in the newborn intensive care unit (NICU).

	Preface	5
	Preface to Pediatric Critical Care Medicine: Basic Science and Clinical Evidence	6
	Contents	8
	Contributors	10
	Chapter 1: Developmental Cardiac Physiology	13
	Cardiomyocytes	13
	A Primer on Cardiac Embryology	13
	Autonomic Innervation of the Heart	17
	Transition from Fetus to Neonate	19
	Conclusion	21
	Chapter 2: Hemodynamic Monitoring	24
	Cardiac Output	24
	Introduction	24
	Vascular Pressure Measurement	24
	Measuring the Adequacy of Flow	32
	Regional Perfusion	34
	Assessing the Components of Cardiac Output	35
	Chapter 3: Cardiopulmonary Interactions	44
	Introduction	44
	The Cardiopulmonary Circulation	44
	The Effect of Changes in Intrathoracic Pressure on Heart Function	47
	Cardiorespiratory Function and Heart Disease	52
	Heart–Lung Interactions in Sepsis and Acute Respiratory Distress Syndrome	58
	Conclusion	60
	Chapter 4: Echocardiography in the Pediatric Critical Care Setting	66
	Is There Systolic Dysfunction?	66
	Introduction	66
	Is There Pericardial Tamponade?	66
	Is There Diastolic Dysfunction?	67
	Does the Patient Have Pulmonary Hypertension?	68
	What Is the Volume Status of the Patient?	69
	Does the Patient Have a Significant Residual Postoperative Lesion?	69
	Does the Patient Have Pulmonary Arteriovenous Malformations?	70
	Does the Patient Have a Cardiac Contusion?	70
	Does the Patient Have an Intracardiac Thrombus?	70
	Are There Intracardiac Vegetations?	70
	Conclusion	71
	Chapter 5: Cardiac Catheterization in the Pediatric Critical Care Setting	73
	Introduction	73
	Indications	73
	Practical Considerations	74
	Sedation and Anesthesia	76
	Vascular Access	77
	Course of Catheterization	79
	Angiography	79
	Hemodynamic Determinations	81
	Emergency Cardiac Catheterization	83
	Complications	83
	Cardiac Catheterization in Specific Circumstances	84
	Applying Catheterization Principles at the Bedside	85
	Summary of Hemodynamic Calculations	85
	Chapter 6: Introduction to Congenital Heart Disease: Nomenclature and Classification	87
	Introduction	87
	Van Praagh’s Segmental Approach to the Classification of Congenital Heart Disease	87
	An Alternative Approach to the Classification of Congenital Heart Disease	88
	International Congenital Heart Surgery Nomenclature and Database	88
	Chapter 7: Palliative Procedures	90
	Historical Perspective	90
	Indications for Palliation	90
	Catheter-Based Palliative Procedures	91
	Intraoperative Assessment of Palliative Procedures	92
	Postprocedure Management	92
	Chapter 8: Congenital Heart Disease: Left-to-Right Shunt Lesions	94
	Introduction	94
	Patent Ductus Arteriosus	94
	Atrial Septal Defect	95
	Ventricular Septal Defect	96
	Atrioventricular Canal Defects	98
	Aortopulmonary Window Defects	99
	Chapter 9: Congenital Heart Disease: Cyanotic Lesions with Decreased Pulmonary Blood Flow	101
	Introduction	101
	Initial Evaluation and Stabilization of the Cyanotic Neonate	101
	Common Postoperative Concerns	103
	Tetralogy of Fallot	104
	Pulmonary Valve Stenosis	107
	Pulmonary Atresia with Intact Ventricular Septum	108
	Ebstein’s Anomaly	109
	Chapter 10: Congenital Heart Disease: Left Ventricular Outflow Tract Obstruction	114
	Valvar Aortic Stenosis	114
	Coarctation of the Aorta	116
	Interrupted Aortic Arch	117
	Supravalvar Aortic Stenosis	118
	Subvalvar Aortic Stenosis	119
	Chapter 11: Congenital Heart Disease: Cyanotic Lesions with Increased Pulmonary Blood Flow	122
	Introduction	122
	Transposition of the Great Arteries	123
	Truncus Arteriosus	124
	Total Anomalous Pulmonary Venous Connection	125
	Single-Ventricle Anomalies with Unobstructed Pulmonary Blood Flow	126
	Chapter 12: Single-Ventricle Lesions	128
	Introduction	128
	The Neonate with Single-Ventricle Physiology	128
	A Rational Approach to Single-Ventricle Physiology in the Newborn	130
	A Rational Approach to Single-Ventricle Physiology in the Older Infant and Child	132
	Chapter 13: Vascular Rings and Associated Malformations	138
	Embryology/Pathology	138
	Historical Perspective and Surgical Milestones	138
	Presentation and Clinical Evaluation	141
	Surgical and Intensive Care Unit Management	143
	Outcomes	147
	Conclusion	147
	Chapter 14: Cardiopulmonary Bypass	149
	Historical Perspective	149
	Components of the Cardiopulmonary Bypass Circuit	150
	Conduct of Cardiopulmonary Bypass	152
	The Inflammatory Response to Cardiopulmonary Bypass	156
	Blood Flow Strategies: Circulatory Arrest and Regional Perfusion	157
	Ultrafiltration: Conventional, Modified, and Zero Balance	157
	Chapter 15: Pediatric Myocardial Protection	164
	Special Features of the Neonatal Myocardium	164
	Introduction	164
	Effects of Cardiopulmonary Bypass on the Myocardium	165
	Delivery Systems	166
	Hypothermia and Cardioplegia	166
	Additives and Compositions of Cardioplegia	167
	Leukocyte Depletion	168
	Terminal Reperfusion	168
	Ischemic Preconditioning	168
	Experimental Myocardial Protection	169
	Myocardial Protection During Transplantation	170
	Chapter 16: Postoperative Care of the Pediatric Cardiac Surgical Patient	174
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