Inpatient Pathway for the Evaluation/Treatment of the Newborn with TGA

Recovery to Discharge POD 1 to discharge

Hemodynamics
  • Convert to enteral diuretics
  • Obtain ECHO prior to discharge
Respiratory Support
  • Wean nasal cannula for sats > 92% with goal of RA within 48 hours of extubation
  • Pulmonary toilet
Pain Management Convert to oxycodone and Tylenol
Neurological Support
  • Continue EEG monitoring for 48 hours post-op
  • Consult Neurology for post-op seizures
Fluids Decrease and discontinue fluids as nutrition advanced
Nutrition
  • Calorie goals 110 to 120 kilo calories/kg daily
  • Adjust calorie intake to maintain weight gain
  • Initiate NG feeds if:
    • PO intake fails to meet fluid/calorie requirements within 24 to 48 hours post-extubation
  • Discoordinated feeding consult speech therapy
  • If stridor present, consult ENT for vocal cord evaluation and Speech Therapy to assess for aspiration
Laboratory Studies BMP, magnesium, phosphate, CBC on POD 1
Lines and Drains Remove
Infectious Disease DC cefazolin on POD #1