1% of babies are born with congenital heart defects, wherein the structure of the heart is abnormal. 1 in 4 of these have critical defects that usually require a procedure or corrective surgery in infancy and some can be fatal if not recognized and treated promptly in the newborn period.
Bottom Line: Approach to cyanotic congenital heart disease in the newborn
Cheung C
Cheung C
This document summarizes causes, symptoms, and management of cyanosis in newborns.
Bottom Line: Approach to cyanotic congenital heart disease in the newborn
Cheung C
Cheung C
This document summarizes causes, symptoms, and management of cyanosis in newborns.
Clinical Practice Guideline: Resuscitation of blue baby and the use of prostaglandins
Linney M, Gnapragassam J, Wilson P, Rodd I
Linney M, Gnapragassam J, Wilson P, Rodd I
This document relates to the acute management of infants presenting acutely with collapse and/or cyanosis suggestive of congenital heart defect.
Clinical Practice Guideline: Resuscitation of blue baby and the use of prostaglandins
Linney M, Gnapragassam J, Wilson P, Rodd I
Linney M, Gnapragassam J, Wilson P, Rodd I
This document relates to the acute management of infants presenting acutely with collapse and/or cyanosis suggestive of congenital heart defect.
Systematic Review: Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis
Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK
Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK
Objective: To assess the performance of pulse oximetry as a screening method for the detection of critical congenital heart defects in asymptomatic newborn babies.
Systematic Review: Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis
Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK
Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK
Objective: To assess the performance of pulse oximetry as a screening method for the detection of critical congenital heart defects in asymptomatic newborn babies.
Overview of studies: Congenital Heart Disease In Pediatric Patients: Recognizing The Undiagnosed And Managing Complications In The Emergency Department
Judge P, Meckler G
Judge P, Meckler G
Objective: This review focuses on the recognition and initial management of patients with undiagnosed congenital heart disease presenting to the ED and touches on considerations for postoperative infants and children with complex congenital heart disease.
Key Study: The Critically Ill Infant with Congenital Heart Disease
Strobel, AM & Lu, N.
Strobel, AM & Lu, N.
Objective: This article presents an approach for identification of infants with congenital heart disorders.
Key Study: Reappraisal of the prostaglandin E1 dose for early newborns with patent ductus arteriosus-dependent pulmonary circulation
Huang FK, Lin CC, Huang TC, Weng KP, Liu PY, Chen YY, Wang HP, Ger LP, Hsieh KS
Huang FK, Lin CC, Huang TC, Weng KP, Liu PY, Chen YY, Wang HP, Ger LP, Hsieh KS
Objective: To review our experience of a low initial dose of PGE1 treatment in early newborns with congenital heart disease and patent ductus arteriosus (PDA)-dependent pulmonary flow.
Key Study: Congenital heart disease
Dolbec K, Mick NW
Dolbec K, Mick NW
This publication provides an overview of the presentations of congenital heart defects, and makes diagnosis and management recommendations for emergency physicians.
Key Study: Impact of oxygen saturation targets and oxygen therapy during the transport of neonates with clinically suspected congenital heart disease
Shivananda S, Kirsh J, Whyte HE, Muthalally K, McNamara PJ
Shivananda S, Kirsh J, Whyte HE, Muthalally K, McNamara PJ
Objective: To determine the effect of average SpO(2) range and oxygen administration during neonatal transport on clinical markers of cardiovascular instability.
Key Study: Approach to diagnosing congenital cardiac disorders
Hartas GA, Tsounias E, Gupta-Malhotra M
Hartas GA, Tsounias E, Gupta-Malhotra M
Objective: To give a general picture of the diagnostic approach to a multitude of heart defects.
Key Study: To intubate or not to intubate? Transporting infants on prostaglandin E1
Meckler GD, Lowe C
Meckler GD, Lowe C
This document describes the pretransport and transport management of infants receiving prostaglandin E(1) infusion for congenital heart disease and compares transport complications among unintubated and electively intubated infants.
Overview of studies: Emergency presentation of congenital heart disease in children
EB Medicine
EB Medicine
Objective: To address the evaluation and management of pediatric patients with congenital heart defects in the context of the evidence available from the medical literature.
Key Study: Lessons from transporting newborn infants with known or suspected congenital heart disease
Bouchut JC, Teyssedre S
Bouchut JC, Teyssedre S
This study presents the results of an evaluation of transporting, by a nonspecialized emergency medical service, neonates with known or suspected cardiac abnormalities.
Key Study: Evaluation and management of the cyanotic neonate
Steinhorn RH
Steinhorn RH
This document discusses the potential challenges in recognizing cyanosis, including the presence of higher concentrations of fetal hemoglobin, and its oxygen binding characteristics.
Key Study: Transporting newborn infants with suspected duct dependent congenital heart disease on low-dose prostaglandin E1 without routine mechanical ventilation
Browning Carmo KA, Barr P, West M, Hopper NW, White JP, Badawi N
Browning Carmo KA, Barr P, West M, Hopper NW, White JP, Badawi N
Objective: To evaluate the safety of transporting newborn infants with suspected duct dependent congenital heart disease (CHD) treated with prostaglandin E1 (PGE1) without routine mechanical ventilation.
Key Study: Cardiac emergencies in the first year of life
Yee L
Yee L
This document discusses the most common causes of cyanotic and acyanotic heart disease in infants.
Key Study: ABC of clinical electrocardiography: Paediatric electrocardiography
Goodacre S, McLeod K
Goodacre S, McLeod K
General clinicians and junior paediatricians may have little experience of interpreting paediatric electrocardiograms. Although the basic principles of cardiac conduction and depolarisation are the same as for adults, age related changes in the anatomy and physiology of infants and children produce normal ranges for electrocardiographic features that differ from adults and vary with age. Awareness of these differences is the key to correct interpretation of paediatric electrocardiograms.
Key Study: Management of the neonate with symptomatic congenital heart disease
Penny DJ, Shekerdemian LS
Penny DJ, Shekerdemian LS
This document addresses some of the principles on which resuscitation and stabilisation of the symptomatic neonate with congenital heart disease may be based.
Key Study: Prevalence and clinical significance of cardiac murmurs in neonates
Ainsworth S, Wyllie JP, Wren C
Ainsworth S, Wyllie JP, Wren C
Objective: To determine the prevalence and clinical significance of murmurs detected during routine neonatal examination.
Key Study: Differentiation of systemic infection and congenital obstructive left heart disease in the very young infant
Pickert CB, Moss MM, Fiser DH
Pickert CB, Moss MM, Fiser DH
This retrospective review of critically ill infants 0 to 28 days of age presenting with either bacterial sepsis or meningitis or a congenital obstructive left heart syndrome (COLHS), identifies historical, physical, or laboratory findings which might differentiate the two groups at presentation.
Key Study: Evaluation of low dose prostaglandin E1 treatment for ductus dependent congenital heart disease
Kramer HH, Sommer M, Rammos S, Krogmann O
Kramer HH, Sommer M, Rammos S, Krogmann O
This study reports experience with low-dose prostaglandin E1 (PGE1) treatment of 91 newborns with ductus dependent congenital heart disease (CHD).
Overview of studies: Congenital Heart Disease In Pediatric Patients: Recognizing The Undiagnosed And Managing Complications In The Emergency Department
Judge P, Meckler G
Judge P, Meckler G
Objective: This review focuses on the recognition and initial management of patients with undiagnosed congenital heart disease presenting to the ED and touches on considerations for postoperative infants and children with complex congenital heart disease.
Key Study: The Critically Ill Infant with Congenital Heart Disease
Strobel, AM & Lu, N.
Strobel, AM & Lu, N.
Objective: This article presents an approach for identification of infants with congenital heart disorders.
Key Study: Reappraisal of the prostaglandin E1 dose for early newborns with patent ductus arteriosus-dependent pulmonary circulation
Huang FK, Lin CC, Huang TC, Weng KP, Liu PY, Chen YY, Wang HP, Ger LP, Hsieh KS
Huang FK, Lin CC, Huang TC, Weng KP, Liu PY, Chen YY, Wang HP, Ger LP, Hsieh KS
Objective: To review our experience of a low initial dose of PGE1 treatment in early newborns with congenital heart disease and patent ductus arteriosus (PDA)-dependent pulmonary flow.
Key Study: Congenital heart disease
Dolbec K, Mick NW
Dolbec K, Mick NW
This publication provides an overview of the presentations of congenital heart defects, and makes diagnosis and management recommendations for emergency physicians.
Key Study: Impact of oxygen saturation targets and oxygen therapy during the transport of neonates with clinically suspected congenital heart disease
Shivananda S, Kirsh J, Whyte HE, Muthalally K, McNamara PJ
Shivananda S, Kirsh J, Whyte HE, Muthalally K, McNamara PJ
Objective: To determine the effect of average SpO(2) range and oxygen administration during neonatal transport on clinical markers of cardiovascular instability.
Key Study: Approach to diagnosing congenital cardiac disorders
Hartas GA, Tsounias E, Gupta-Malhotra M
Hartas GA, Tsounias E, Gupta-Malhotra M
Objective: To give a general picture of the diagnostic approach to a multitude of heart defects.
Key Study: To intubate or not to intubate? Transporting infants on prostaglandin E1
Meckler GD, Lowe C
Meckler GD, Lowe C
This document describes the pretransport and transport management of infants receiving prostaglandin E(1) infusion for congenital heart disease and compares transport complications among unintubated and electively intubated infants.
Overview of studies: Emergency presentation of congenital heart disease in children
EB Medicine
EB Medicine
Objective: To address the evaluation and management of pediatric patients with congenital heart defects in the context of the evidence available from the medical literature.
Key Study: Lessons from transporting newborn infants with known or suspected congenital heart disease
Bouchut JC, Teyssedre S
Bouchut JC, Teyssedre S
This study presents the results of an evaluation of transporting, by a nonspecialized emergency medical service, neonates with known or suspected cardiac abnormalities.
Key Study: Evaluation and management of the cyanotic neonate
Steinhorn RH
Steinhorn RH
This document discusses the potential challenges in recognizing cyanosis, including the presence of higher concentrations of fetal hemoglobin, and its oxygen binding characteristics.
Key Study: Transporting newborn infants with suspected duct dependent congenital heart disease on low-dose prostaglandin E1 without routine mechanical ventilation
Browning Carmo KA, Barr P, West M, Hopper NW, White JP, Badawi N
Browning Carmo KA, Barr P, West M, Hopper NW, White JP, Badawi N
Objective: To evaluate the safety of transporting newborn infants with suspected duct dependent congenital heart disease (CHD) treated with prostaglandin E1 (PGE1) without routine mechanical ventilation.
Key Study: Cardiac emergencies in the first year of life
Yee L
Yee L
This document discusses the most common causes of cyanotic and acyanotic heart disease in infants.
Key Study: ABC of clinical electrocardiography: Paediatric electrocardiography
Goodacre S, McLeod K
Goodacre S, McLeod K
General clinicians and junior paediatricians may have little experience of interpreting paediatric electrocardiograms. Although the basic principles of cardiac conduction and depolarisation are the same as for adults, age related changes in the anatomy and physiology of infants and children produce normal ranges for electrocardiographic features that differ from adults and vary with age. Awareness of these differences is the key to correct interpretation of paediatric electrocardiograms.
Key Study: Management of the neonate with symptomatic congenital heart disease
Penny DJ, Shekerdemian LS
Penny DJ, Shekerdemian LS
This document addresses some of the principles on which resuscitation and stabilisation of the symptomatic neonate with congenital heart disease may be based.
Key Study: Prevalence and clinical significance of cardiac murmurs in neonates
Ainsworth S, Wyllie JP, Wren C
Ainsworth S, Wyllie JP, Wren C
Objective: To determine the prevalence and clinical significance of murmurs detected during routine neonatal examination.
Key Study: Differentiation of systemic infection and congenital obstructive left heart disease in the very young infant
Pickert CB, Moss MM, Fiser DH
Pickert CB, Moss MM, Fiser DH
This retrospective review of critically ill infants 0 to 28 days of age presenting with either bacterial sepsis or meningitis or a congenital obstructive left heart syndrome (COLHS), identifies historical, physical, or laboratory findings which might differentiate the two groups at presentation.
Key Study: Evaluation of low dose prostaglandin E1 treatment for ductus dependent congenital heart disease
Kramer HH, Sommer M, Rammos S, Krogmann O
Kramer HH, Sommer M, Rammos S, Krogmann O
This study reports experience with low-dose prostaglandin E1 (PGE1) treatment of 91 newborns with ductus dependent congenital heart disease (CHD).
Emergency Medicine Cases Rapid Review: Congenital Heart Disease Part 1
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Emergency Medicine Cases Rapid Review: Congenital Heart Disease Part 2
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Emergency Medicine Cases Podcast: Cyanotic Infant
Dr. Gary Joubert & Dr. Anton Helman
Dr. Gary Joubert & Dr. Anton Helman
Best Case Ever #48: In anticipation of EM Cases’ upcoming episode, Congenital Heart Disease Emergencies, Dr. Gary Joubert discusses his Best Case Ever of a four month old infant who presents with intermittent cyanosis. The Cyanotic Infant can present a significant challenge to the EM provider as the differential is wide, ranging from benign causes such as GERD to life threatening heart disease that may present atypically in a well-appearing child. Dr. Joubert provides some simple clinical pearls to help ED providers along the way. Published online: July 2016.
Emergency Medicine Cases Podcast: Congenital Heart Disease Emergencies
Dr. Gary Joubert & Dr. Ashley Strobel
Dr. Gary Joubert & Dr. Ashley Strobel
Episode 84: You might be surprised to learn that the prevalence of critical cardiac disease in infants is almost as high as the prevalence of infant sepsis. Critical congenital heart defects are often missed in the ED. For a variety of reasons, there are currently more children with congenital heart disease presenting to the ED than ever before and these numbers will continue to grow in the future. With the goal of learning a practical approach to congenital heart disease emergencies using the child’s age, colour and few simple tests, Dr. Strobel and Dr. Joubert will discuss some key actions, pearls and pitfalls so that the next time you’re faced with that crashing baby in the resuscitation room, you’ll know exactly what to do. This podcast topic was chosen based on a Canada-wide needs assessment by TREKK – translating emergency knowledge for kids.
Published online: August 2016.
Emergency Medicine Cases Rapid Review: Congenital Heart Disease Part 1
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Emergency Medicine Cases Rapid Review: Congenital Heart Disease Part 2
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Gilbride P, Lloyd T, Cheng E, Calldrige N & Yee M
Emergency Medicine Cases Podcast: Cyanotic Infant
Dr. Gary Joubert & Dr. Anton Helman
Dr. Gary Joubert & Dr. Anton Helman
Best Case Ever #48: In anticipation of EM Cases’ upcoming episode, Congenital Heart Disease Emergencies, Dr. Gary Joubert discusses his Best Case Ever of a four month old infant who presents with intermittent cyanosis. The Cyanotic Infant can present a significant challenge to the EM provider as the differential is wide, ranging from benign causes such as GERD to life threatening heart disease that may present atypically in a well-appearing child. Dr. Joubert provides some simple clinical pearls to help ED providers along the way. Published online: July 2016.
Emergency Medicine Cases Podcast: Congenital Heart Disease Emergencies
Dr. Gary Joubert & Dr. Ashley Strobel
Dr. Gary Joubert & Dr. Ashley Strobel
Episode 84: You might be surprised to learn that the prevalence of critical cardiac disease in infants is almost as high as the prevalence of infant sepsis. Critical congenital heart defects are often missed in the ED. For a variety of reasons, there are currently more children with congenital heart disease presenting to the ED than ever before and these numbers will continue to grow in the future. With the goal of learning a practical approach to congenital heart disease emergencies using the child’s age, colour and few simple tests, Dr. Strobel and Dr. Joubert will discuss some key actions, pearls and pitfalls so that the next time you’re faced with that crashing baby in the resuscitation room, you’ll know exactly what to do. This podcast topic was chosen based on a Canada-wide needs assessment by TREKK – translating emergency knowledge for kids.
Published online: August 2016.