Bypass - Post-Operative Care of Congenital Heart Disease Patients A brief pediatrics perspective Electrolytes • Severe electrolyte abnormalities

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Unformatted text preview: Post-Operative Care of Congenital Heart Disease Patients A brief pediatrics perspective Electrolytes • Severe electrolyte abnormalities – Cause: Pump solutions, saline solutions, fluid shifts. – Most important are those with effects on heart • Potassium (arrhythmogenic) • Calcium (affects contractility and arrhythmias) • Magnesium (same as Ca) – Also, but less important • Sodium and phosphate Glucose • Hyperglycemia (outside of neonatal period) • Causes: – Stress response • Endogenous steroids • Epinephrine – Steroids given for bypass • Tx: Incr sedation & pain control Renal Effects • All due to decr MAP and non-pulsatile flow. • Release of – Angiotensin • Causes HTN – ADH • Causes retention of free water leading to hyponatremia – Catecholamines • Causes HTN and faster heart rate. • Tx: Antihypertensives, Lasix. Renal Effects, cont. • Acute Renal Insufficiency (incidence 8%) – Oliguria – Incr creatinine – Fluid retention • Tx: – MUF – Lasix Pulmonary Effects...
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This note was uploaded on 01/23/2012 for the course PDBIO 305 taught by Professor Woods,a during the Fall '08 term at BYU.

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Bypass - Post-Operative Care of Congenital Heart Disease Patients A brief pediatrics perspective Electrolytes • Severe electrolyte abnormalities

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