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Cardiopulmonary bypass considerations for pediatric patients on the ketogenic diet.

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  • معلومة اضافية
    • المصدر:
      Publisher: SAGE Publications Country of Publication: England NLM ID: 8700166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-111X (Electronic) Linking ISSN: 02676591 NLM ISO Abbreviation: Perfusion Subsets: MEDLINE
    • بيانات النشر:
      Publication: London : SAGE Publications
      Original Publication: [London] : Edward Arnold, [c1986-
    • الموضوع:
      Diet, Ketogenic*; Cardiopulmonary Bypass/*methods ; Monitoring, Physiologic/*methods ; Seizures/*therapy; Child, Preschool ; Humans ; Ketosis/blood ; Ketosis/physiopathology ; Male ; Seizures/blood ; Seizures/physiopathology
    • نبذة مختصرة :
      Background: There is a population of children with epilepsy that is refractory to anti-epileptic drugs. The ketogenic diet, a high-fat, low-carbohydrate regimen, is one alternative treatment to decrease seizure activity. Special considerations are required for patients on the ketogenic diet undergoing cardiopulmonary bypass (CPB) to prevent exposure to glucose substrates that could alter ketosis, increasing the risk of recurrent seizures.
      Case Study: A 2-year-old, 9 kilogram male with a history of infantile spasms with intractable epilepsy, trisomy 21 status post tetralogy of Fallot repair, presented to the cardiac operating room for closure of a residual atrial septal defect. All disciplines of the surgical case minimized the use of carbohydrate-containing and contraindicated medications. Changes to the standard protocol and metabolic monitoring ensured the patient maintained ketosis.
      Discussion: All disciplines within cardiac surgery need to be cognizant of patients on the ketogenic diet and prepare a modified protocol. Future monitoring considerations include thromboelastography, electroencephalography and continuous glucose measurement. Key areas of focus with this patient population in the cardiac surgical theater are to maintain a multidisciplinary approach, alter the required CPB prime components, address cardiac pharmacological concerns and limit any abnormal hematological occurrences.
      (© The Author(s) 2014.)
    • Contributed Indexing:
      Keywords: cardiopulmonary bypass; epilepsy; glucose; ketogenic diet; pediatrics
    • الموضوع:
      Date Created: 20141109 Date Completed: 20160301 Latest Revision: 20171116
    • الموضوع:
      20231215
    • الرقم المعرف:
      10.1177/0267659114559118
    • الرقم المعرف:
      25381016