Pearls • Both the cardiac and thoracic pump mechanisms play a role in infants and children during cardiopulmonary resuscitation. Thus, attention to excellent chest compression technique—with an emphasis on “push…
Pearls • There are four distinct phases of cardiac arrest and cardiopulmonary resuscitation (CPR): prearrest, no-flow (untreated cardiac arrest), low-flow (CPR), and postarrest. • The most common precipitating event for…
Pearls • Cardiopulmonary bypass (CPB), which originated in the mid-twentieth century, was designed to allow for the repair of congenital heart defects. Its history has since been characterized by perpetual…
Pearls • Most pediatric transplantations are performed for cardiomyopathy or congenital heart disease not amenable to correction or palliation. • Individuals may have a good quality of life following heart…
Pearls • The neonatal myocardium is less compliant than that of the older child, less tolerant of increases in afterload, and less responsive to increases in preload. A predictable decrease…
The clinical syndrome of shock is one of the most dramatic, dynamic, and life-threatening problems faced by the physician in the critical care setting. Although untreated shock is universally lethal,…
Pearls • Arrhythmias may result from ongoing therapies; ask, “What’s the DEAL?” ( d rugs and drips, e lectrolytes, a irway and acid-base, l ines). • Appropriate diagnosis is key….
Pearls • Positive-pressure ventilation (PPV) alters ventricular loading conditions and compliance. • In patients who are hypovolemic, the effects of positive airway pressure on the right heart predominate, whereas in…
Pearls • The intensive care unit is a unique environment for performing an echocardiogram; the intensivist, sonographer, and pediatric cardiologist must work together to obtain the needed information with minimal…
Pearls • Clinical acumen and knowledge of physiology is needed to distinguish between the need for an inotropic agent, which is used to increase cardiac contractility, and the need for…
