CICU/CCU Clinical Pathway for the Evaluation/Treatment
of Fetus or Newborn with Single Ventricle
Perioperative care
- Perioperative guidelines for neonates undergoing Norwood operation
- Identify pre-op patient factors
- Identify comorbidities
- Case conference discussion
- OR team schedule
- Evaluate/enroll in Single Ventricle Monitoring Program
Intraoperative care
- Intraoperative guidelines for Neonates undergoing Norwood operation
- Hemodynamic monitoring
- Vascular access
- Anesthesia plan
- Airway management
- Cardiopulmonary bypass
- Medications
- Hemostasis
- OR team debrief, OR to CICU handoff
Post-operative Care
- Post-operative guidelines days 0-2 after Norwood operation
- Hemodynamic monitoring
- Respiratory support
- Fluid management
- Pain management — CICU Sedation Pathway
- Medications
- Nutrition — Nutrition for CHD Pathway
De-intensification within 4 days
- Achieved
Not achieved
- Detailed post-op echo
- Echo procedure for Norwood
- Echo procedure for Hybrid
Convalescence and discharge planning
- CCU DC attending to discuss surgical planning with primary cardiologist and consider submission of paperwork for surgery
- OT/PT consults
- Social work, case management consults
- Parent discharge checklist – View checklist
- Feeding advancement
- Detailed Post-op echo within 7 days of operation
- Perform Routine echo surveillance while inpatient
- Stage I: every 2 weeks, focused echo
- Hybrid: weekly
Discharge
- Assess discharge readiness
- Review parent discharge checklist – View checklist
- ISVMP APRN
- Contacts community providers
- Sends information, protocols, patient reports
Posted: July 2011
Reviewed: April 2020
Authors: T. Giglia, MD, A. Stagg, CRNP, S. Natarajan, MD
Reviewed: April 2020
Authors: T. Giglia, MD, A. Stagg, CRNP, S. Natarajan, MD
Evidence
Community Resources
CHOP Programs