Anesthesia for congenital heart disease / editors, Dean B. Andropoulos MD, MHCM [and three others].

Format:

Book

Contributor:

Andropoulos, Dean B., editor.

Language:

English

Subjects (All):

Congenital heart disease--Surgery.

Congenital heart disease.

Congenital heart disease in children--Surgery.

Congenital heart disease in children.

Anesthesia in cardiology.

Pediatric anesthesia.

Physical Description:

1 online resource (819 pages) : illustrations (some color), photographs

Edition:

Third edition.

Place of Publication:

Hoboken, New Jersey : Wiley, 2015.

Language Note:

English

Summary:

The third edition of Anesthesia for Congenital Heart Disease, the recognized gold-standard reference in this field, offers a major update and expansion of the textbook to reflect the ongoing development of the practice of pediatric and congenital cardiac anesthesia and the burgeoning knowledge base in this exciting field. Includes two new chapters addressing key areas; anesthetic and sedative neurotoxicity in the patient with congenital heart disease, and anesthesia in the patient with pulmonary hypertension Now in full color, with over 200 illustrations and photographs Multiple-choice questions accompany each chapter covering the most crucial learning points to optimize the learning experience for readers at all levels.

Contents:

Cover

Title Page

Copyright

Contents

List of Contributors

Preface

List of Abbreviations

About the Companion Website

Part I History, Education, Outcomes, and Science

Chapter 1 History of Anesthesia for Congenital Heart Disease

Introduction

The first years: 1938-1954

The heart-lung machine: 1954-1970

The era of deep hypothermic circulatory arrest and the introduction of PGE1: 1970-1980

PDA and the introduction of PGE1

The story of HLHS: 1980-1990

Fontan and the catheterization laboratory: 1990-2000

Emergence of technology, including imaging (TEE, MRI) and ECMO: 2000-2010

2011-2015 and the future

CHD - a growing specialty from the fetus to the adult patient

Selected references

Chapter 2 Education for Anesthesia in Patients with Congenital Cardiac Disease

Why teach and learn congenital cardiac anesthesia?

The current model

Curriculum for learning and teaching congenital cardiac anesthesia

Problem identification and general needs assessment

Targeted needs assessment

Goals and objectives

Educational strategies

Implementation

Evaluation and feedback

Curriculum maintenance and enhancement

Dissemination

Role of professional societies

Conclusion

Selected References

Chapter 3 Quality, Outcomes, and Databases in Congenital Cardiac Anesthesia

Errors and outcomes in surgery and anesthesia

The six "Cs": communication and teamwork

Databases in pediatric cardiac surgery and anesthesiology

Prospective risk assessment in pediatric cardiac surgery and cardiology

Closed claims analysis in anesthesia

Pediatric and congenital cardiac anesthesia morbidity and mortality

CCAS and the Congenital Cardiac Anesthesia Network (CCAN)

Joint CCAS-STS database initiative

International efforts

Selected References.

Chapter 4 Development of the Cardiovascular System and Nomenclature for Congenital Heart Disease

Development of the cardiovascular system

New concept of cardiac development

Cardiovascular development: normal and abnormal

Summary - development of the cardiovascular system

Nomenclature for congenital heart disease

Sequential segmental approach to diagnosis

Morphologic and segmental anatomy

Right atrium

Left atrium

Morphologic right ventricle

Morphologic left ventricle

Summary - nomenclature for CHD

Chapter 5 Physiology and Cellular Biology of the Developing Circulation

Development from fetus to neonate

Circulatory pathways

Myocardial contractility

Development from neonate to older infant and child

Gene expression in cardiac development

The extracellular matrix

Cell-to-cell connectivity

Innervation of the heart

Development from child to adult

Normal values for physiologic variables by age

Myocardial sequelae of longstanding CHD

Cardiomyocyte receptor function in normal and diseased hearts

The adrenergic receptor

Developmental changes in adrenergic receptor signaling

Calcium cycling in the normal heart

Developmental changes in calcium cycling

Thyroid hormone

Regulation of vascular tone in systemic and pulmonary circulations

Pulmonary circulation

Systemic circulation

Receptor signaling in myocardial dysfunction, CHD, and heart failure

Receptor signaling in acute myocardial dysfunction

Receptor signaling in CHD

Receptor signaling in congestive heart failure and cardiomyopathy

Myocardial preconditioning

Chapter 6 Anesthetic Agents and Their Cardiovascular Effects

Volatile agents

Nitrous oxide (N2O)

Opioids and benzodiazepines

Propofol.

Ketamine

Etomidate

Dexmedetomidine

Special conditions affecting anesthetic pharmacokinetics and pharmocodynamics in congenital cardiac anesthesia

Intracardiac shunts

Cardiopulmonary bypass

Hypothermia

Neuromuscular blocking agents and antagonists

Succinylcholine

Pancuronium

Vecuronium

Rocuronium

Atracurium and cisatracurium

Antagonists

Selection of anesthetic regimen in CHD

Chapter 7 Cardiopulmonary Bypass

Basic bypass circuit setup

Cannulation and tubing

Pumps

Oxygenator

Priming

Differences between pediatric and adult CPB circuitry

Hemodilution

Perfusion pressures

Flow rates

Blood gas management

Aortopulmonary collaterals

Temperature ranges

Glucose management

Management of pediatric CPB

Stages of CPB

Pre-bypass period

Anticoagulation and hemostatic management

Initiation of CPB and flow requirements

Cooling and temperature management

Aortic cross-clamping, myocardial ischemia, and protection

Induction and maintenance of cardioplegic cardiac arrest

Reperfusion

Separation from CPB and post-bypass phase

Conventional ultrafiltration and modified ultrafiltration

Failure to separate from CPB

Heparin reversal and transfusion management

Antifibrinolytic therapy

Effects of CPB on organ systems

Neurological injury and protection

Pulmonary effects

Renal, hepatic, and gastrointestinal effects

Endocrine and metabolic response to CPB

Special CPB management issues

Warm CPB

Deep hypothermic circulatory arrest

Regional cerebral perfusion

Blood gas management: pH-stat vs. alpha-stat

Sickle cell disease

Cold agglutinins

Leukoreduction and irradiation of blood products

Monitoring anticoagulation during and after CPB

Complications and safety.

Conclusions and future perspectives

Chapter 8 Multiorgan Effects of Congenital Cardiac Surgery

The systemic inflammatory response and congenital cardiac surgery

Systems mediating the systemic inflammatory response to CPB

Mitigating the deleterious inflammatory effects of CPB

Corticosteroids

Modified ultrafiltration

Serine protease inhibitors

Heparin-bonded circuits

Transfusion and inflammation

Effects of congenital heart surgery on coagulation, hemostasis, and thrombosis

Disturbances in the coagulation system in pediatric cardiac surgery

Unique aspects of pediatric coagulation

Hemostasis in CHD

Pediatric patients and CPB

Risk factors for hemorrhagic complications in pediatric cardiac surgery

Optimization of transfusion management in pediatric cardiac surgery

Thrombosis in pediatric cardiac surgery

Pulmonary effects of congenital heart surgery

Neonatal and pediatric pulmonary physiology: a compromised state

Metabolic compromise

Mechanical compromise

Ventilatory compromise

Compromise of neonatal oxygen delivery

Compromise arising from CHD

Effects of CPB on pulmonary physiology in children

Renal effects of congenital heart surgery

Introduction, incidence, and definition of the problem

Emerging biomarkers of renal dysfunction

Association of renal injury with clinical outcomes

Renal failure and renal replacement therapy following cardiac surgery in children

Peritoneal dialysis

Continuous veno-venous hemofiltration

Gastrointestinal and hepatic consequences of cardiac surgery in children

Splanchnic circulation

Hepatic dysfunction

Endocrine response and pediatric cardiac surgery

Diagnosis of CIRCI

Management of CIRCI

Stress hyperglycemia

Chapter 9 Anesthetic and Sedative Neurotoxicity in the Patient with Congenital Heart Disease

Preclinical studies in animal and tissue culture models

Mechanisms of anesthesia-induced neurotoxicity

Mitochondria, oxidative stress, and the intrinsic apoptosis pathway

The extrinsic apoptosis pathway

Brain-derived neurotrophic factor

Cell age-specific vulnerability

Summary of human cardiac cohorts

Experimental therapy in preclinical studies

Anesthetic preconditioning

Erythropoietin

Lithium

Vitamins, anti-inflammatory agents, and antioxidants

Carbon monoxide

Xenon

Future therapy

Preconditioning

Low-flow anesthesia

Directions for future research

Part II Monitoring

Chapter 10 Vascular access and monitoring

Venous access

Peripheral venous access

Central venous access

Arterial access

Radial artery

Femoral artery

Brachial artery

Axillary artery

Umbilical artery

Temporal artery

Dorsalis pedis/posterior tibial arteries

Ulnar artery

Arterial cutdown

Ultrasound guidance for vascular access in congenital heart surgery

Sonoanatomy

Ultrasound-guided peripheral vein access

Ultrasound-guided central vascular access

Ultrasound-guided arterial catheterization

Percutaneous PA catheterization

Interpretation of intravascular pressure waveforms

Arterial pressure waveform

Central venous and left atrial waveforms

New techniques in pediatric intravascular monitoring

CO monitoring

Central venous oxygen saturation monitoring

Complications of vascular access

Incidence and risk factors

Thrombosis

Infection

Insertion bundle

Maintenance bundle

Malposition/perforation

Pneumothorax/hemothorax.

Cardiac tamponade.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographical references at the end of each chapters and index.

Description based on online resource; title from PDF title page (ebrary, viewed July 25, 2015).

ISBN:

1-118-76809-4

1-118-76812-4

OCLC:

913869174