Cognitive aids are designed to prompt users to complete a series of tasks and can take many different forms. We have designed a series of cognitive aids for congenital cardiac anesthesia for common … [Read More...]
CCAS is a society organized within the Society for Pediatric Anesthesia. The CCAS concept originated with cardiac anesthesia directors and other key leaders at major congenital heart disease programs, who believed there was a need for a new society because of rapid advancement of highly specialized knowledge in the field, and a great increase in the numbers of patients, including adults with congenital heart disease.
Question of the Week
A 6-month-old infant is undergoing a full repair for Tetralogy of Fallot. The patient separates from cardiopulmonary bypass (CPB) on milrinone 0.05 mcg/kg/min, dexmedetomidine 0.5 mcg/kg/h and morphine 0.025 mg/kg/h. The surgeon measures a right ventricular (RV)-to-aortic pressure ratio of 0.5, and right ventricular outflow tract (RVOT) gradient of 30 mmHg. Ten minutes later the vital signs are: BP 50/38, HR 167 bpm in sinus rhythm, SpO2 100%, with adequate anesthetic depth. The transesophageal echocardiogram (TEE) is now showing hyperdynamic right ventricular systolic function with subvalvar obstruction. In addition to volume administration, what is the recommended next step in management?
A. Return to CPB for reintervention
B. Administer calcium
C. Bolus esmolol and begin an infusion