Cardiovascular Problems

why do children's pulse rates change as they get older?

Can anyone please explain pathophysiological mechanism of changes in cardiovascular system after balloon atrioseptostomy in children with TGA? I commonly observe that these babies require large volume of fluids, including boluses to maintain proper cardiovascular performance immediately after the procedure. They are often very responsive to rapid fluid administration even though the intracardiac volemia seems adequate.

Any one with experience in the use of Methylene Blue for hypotension refractory to multiple pressors?

Neonatal Hemodynamics: From Developmental Physiology to Comprehensive Monitoring https://www.frontiersin.org/articles/10.3389/fped.2018.00087/full?

Good morning everyone, On occasion we have taken note of the Pro BNP level in an infant with an hHsPDA who may or may not warrant Ibuprofen. Does anyone use BNP as a guide to the treatment or current state of the PDA as a point of care? Any thoughts on the role of BNP greatly appreciated. Kind regards Al

I guess many took impression by data from the TIPP-trial, that suggested that surgical ligation of PDA was associated with increased risks of BPD, ROP and neurosensory impairment. http://www.jpeds.com/article/S0022-3476(06)01108-5/abstract Data from a recent and relatively large cohort in Canada, where postnatal preligation morbidities where taken closely into account, has now showed that previous research may be explained by confounding by indication. http://jamanetwork.com/journals/jamapediatrics/article-abstract/2606520 In other words, surgical PDA ligation as such may not be associated with adverse outcomes. Nevertheless, I personally believe that PDA surger…

Dear all, I would like to know if any units as of now have started to use paracetamol as a treatment for PDA in VLBW/ELBW. There seem to be a few published studies looking at paracetamol as an alternative to indomethacine/ibuprofen and a few studies recruiting at the moment. Personally I am not quite sure what to think, and just wanting to hear if there is any experience out there. cheers Christian

whats and when indication echo in neonate under 1000gr ?

hi every one i want to ask questions regarding shock therapy in cardiogenic shock .. i know its beyond the scope of this forum , but iam looking for an expert answer (practical not theoritical) during my cardiology rotation. ive seen a lot of cases in late neonatal peroid or , more commonly early infancy, knowing or suscpected to have cardiological problem coming in compensated shock phase (tachycardic' poor perfusion , normal bl.p weak pulses , sweating and cold extr) , when i examined the liver, frequently i found it enlarged. some has adviced me to give lasix then fluid 10cc /kg .and here i want to ask whats the best approach in this situatio…

hi every one i want to ask about some practical point in managing hypotention . and here is the situations iam facing in every day practice : - delayed perfusion: ( septic chils or R.D ...etc) we dont wait to document hypotention in order to start therapy .. we give N/s then if no improvment we start iontrops so is it ok to manage and to start dopamine while the baby is still normotensive ??? - M.v babies on sedation Iv , we start dopamine to counter its effect even before documented delayed perfusion or hypotention so is it evidence based practice ? we dont have a protocol to follow , instead we adopt a managment plane in different sett…