Aspects of bleeding after cardiac surgery in children

McEwan, Angus

doi:10.1111/j.1460-9592.2007.02265.x

Cited by 43 publications

(27 citation statements)

References 68 publications

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“…Second, the CPB circuit requires priming with a mixture of allogenic blood and/or crystalloid solutions, e.g., normal saline, which causes a significant hemodilution of clotting factors and platelets. A resulting variable dysfunction of hemostasis is seen in all pediatric patients (4,5).…”

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confidence: 99%

Defining the role of recombinant activated factor VII in pediatric cardiac surgery: Where should we go from here?*

Warren

Rogers²,

Watret³

et al. 2009

Pediatric Critical Care Medicine

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rFVIIa has an increasingly accepted role in the management of patients with congenital coagulopathies undergoing major surgery. However, randomized trials are required to define the role of rFVIIa as an adjunct to control major hemorrhage in the pediatric cardiac surgical population. Any future work must focus not only on benefits but also on patient safety, particularly, risk of morbid thromboembolic complication.

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mentioning

confidence: 99%

Defining the role of recombinant activated factor VII in pediatric cardiac surgery: Where should we go from here?*

Warren

Rogers²,

Watret³

et al. 2009

Pediatric Critical Care Medicine

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show abstract

“…Hemodilution, and the consequent decrease in platelets and coagulation factor, is the most important mechanism for the development of coagulopathy in this clinical situation, due to the large discrepancy in the child's blood volume and the priming volume of the bypass circuit (11) . Following surgical correction of CHD requiring ECMO, bleeding occurs in 63% of pediatric patients (11) mainly due to the need for surface heparinization of the system (12) . Bleeding precautions (Code 4010) is a NIC defined as "reduction of stimuli that may induce bleeding or hemorrhage in at-risk patients" (2) .…”

Section: Discussionmentioning

confidence: 99%

“…The surgical procedure and ECMO are both strongly related to bleeding in children. Neonates and small infants are the highest risk group for excessive bleeding after cardiac surgery (11) . Hemodilution, and the consequent decrease in platelets and coagulation factor, is the most important mechanism for the development of coagulopathy in this clinical situation, due to the large discrepancy in the child's blood volume and the priming volume of the bypass circuit (11) .…”

Section: Discussionmentioning

confidence: 99%

“…Neonates and small infants are the highest risk group for excessive bleeding after cardiac surgery (11) . Hemodilution, and the consequent decrease in platelets and coagulation factor, is the most important mechanism for the development of coagulopathy in this clinical situation, due to the large discrepancy in the child's blood volume and the priming volume of the bypass circuit (11) . Following surgical correction of CHD requiring ECMO, bleeding occurs in 63% of pediatric patients (11) mainly due to the need for surface heparinization of the system (12) .…”

Section: Discussionmentioning

confidence: 99%

“…These interventions primarily include monitoring and observational activities, important components of surveillance: a mental process of sustained attention through which nurses can determine if and when the readiness to rescue the patient from bleeding has become a need for rescue (10) . Although blood loss via chest tubes is expected after cardiac surgeries, the risk of excessive loss requires vigilance with regard to output, coagulation exams and vital signs in order to early detect the need for blood product transfusion as well as transfusion reactions (11) . The NANDA-I ND, impaired spontaneous ventilation (00033), is defined as "decreased energy reserves resulting in an inability to maintain independent breathing that is adequate to support life" (1) .…”

Section: Discussionmentioning

confidence: 99%

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Nursing diagnoses and interventions for a child after cardiac surgery in an intensive care unit

et al. 2015

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Objective: to describe the nursing clinical judgment as a basis for ND identifi cation and development of a NIC treatment plan for a child after cardiac surgery under intensive care. Method: a case study with data retrospectively collected from charts. Results: Three nurses identifi ed NANDA-I diagnoses and NIC interventions. A 6-month-old child submitted to cardiac surgery, requiring extracorporeal membrane oxygenation in the postoperative period. Four main nursing diagnoses were identifi ed, towards which ten interventions were directed. The proposal of interventions to respond to the priority human responses of the child was optimized by the use of standard terminologies. Every nursing diagnosis was supported by diagnostic indicators; every intervention was scientifi cally supported. Conclusion: there must be an expectation that nurses address not only physiological responses, but also those within psychosocial domains. Key words: Nursing Diagnosis; Nursing Care; Controlled Vocabulary; Child; Thoracic Surgery. RESUMO Objetivo: descrever o julgamento clínico de enfermagem para identifi car diagnósticos NANDA e desenvolver um plano de tratamento NIC para uma criança em pós-operatório de cirurgia cardíaca em terapia intensiva. Método: estudo de caso com coleta de dados retrospectiva no prontuário. Resultados: três enfermeiras identifi caram diagnósticos NANDA e intervenções NIC. Criança de 6 meses, submetida a cirurgia cardíaca, necessitou oxigenação extracorpórea por membrana no pós-operatório. Foram identifi cados quatro principais diagnósticos, aos quais foram direcionadas dez intervenções. A proposta de intervenções para responder às necessidades humanas prioritárias da criança foi otimizada pelo uso das terminologias padronizadas. Todos os diagnósticos foram sustentados por indicadores diagnósticos; todas as intervenções foram cientifi camente sustentadas. Conclusão: espera-se que os enfermeiros abordem não somente as respostas fi siológicas, mas também aquelas dos domínios psicossociais. Descritores: Diagnóstico de Enfermagem; Cuidados de Enfermagem; Vocabulário controlado; Criança; Cirurgia Torácica. RESUMEN Objetivo: describir el raciocinio clínico de enfermería para identifi car diagnósticos y planear intervenciones NIC para una niña en el postoperatorio de cirugía cardíaca. Método: estudio de caso con datos recogidos de forma retrospectiva en registros. Resultados: tres enfermeras propusieron diagnósticos NANDA-I e intervenciones NIC. Niña de 6 meses de edad, sometida a cirugía cardíaca requirió oxigenación por membrana extracorpórea en el postoperatorio. Cuatro principales diagnósticos fueron identifi cados para los cuales diez intervenciones de enfermería fueron direccionadas. La propuesta de intervenciones para las respuestas humanas prioritarias de la niña fue optimizada por el uso de terminologías estándar. Todos los diagnósticos fueron apoyados por indicadores, cada intervención apoyada científi camente. Conclusión: los enfermeros deben abordar no sólo las respuestas fi siológicas, sino ...

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Red cell transfusion management for patients undergoing cardiac surgery for congenital heart disease

Wilkinson¹,

Brunskill

Dorée

et al. 2014

Cochrane Database of Systematic Reviews

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Aspects of bleeding after cardiac surgery in children

Cited by 43 publications

References 68 publications

Defining the role of recombinant activated factor VII in pediatric cardiac surgery: Where should we go from here?*

Defining the role of recombinant activated factor VII in pediatric cardiac surgery: Where should we go from here?*

Nursing diagnoses and interventions for a child after cardiac surgery in an intensive care unit

Red cell transfusion management for patients undergoing cardiac surgery for congenital heart disease

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