VEPTR/Spine Growing Instrumentation Procedures Clinical Pathway, ICU and Inpatient – Guidance for Referred Patients

VEPTR/Spine Growing Instrumentation Procedures Clinical Pathway — ICU and Inpatient

Guidance for Referred Patients

For Thoracic Insufficiency, Jeune syndrome, Hypoplastic Chest, and all children potentially eligible for treatment at CHOP Center for Thoracic Insufficiency Syndrome.

  • Call 215-410-2086 between 8 a.m. and 5 p.m., Monday through Friday
  • CHOP Critical Care, Pulmonary, and Orthopedic attendings will determine if appropriate for inpatient hospital to hospital transfer
  • If appropriate for transfer, child will undergo a full comprehensive evaluation to determine their candidacy for VEPTR/spinal growing instrumentation surgery once at CHOP
Pulmonary
  • Establish and maintain effective ventilation and pulmonary clearance regimen prior to transfer
  • Ensure appropriate back-up cuffed tracheostomy tube is available
Mobilization
  • PT and OT to maintain muscle strength and milestones
Skin Care
  • OOB whenever possible to prevent skin breakdown
  • Position changes q2hr
Nutrition
  • Outside hospital obtain the following labs when referral initiated to optimize preoperative nutrition and bone health:
    • CMP, Mag, Phos
    • Prealbumin
    • Vitamin D 25 OH