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VEPTR/Spine Growing Instrumentation Procedures Clinical Pathway, ICU and Inpatient – Pre-Operative Evaluation

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

Pre-Operative Evaluation by the Center for Thoracic Insufficiency (CTIS) to Determine Surgical Candidacy

  Thoracic Insufficiency Syndrome Early Onset Scoliosis
Imaging
  • Thoracic Insufficiency Imaging Panel
    • XR Scoliosis 2 VW Frontal/lat no brace
    • CT chest w/o IV contrast
      • 5 mm cuts, unenhanced with
        3D reconstruction
      • Lung volume calculation
    • Dynamic lung MRI w/o contrast
    • Entire spine MRI w/o contrast
  • Echocardiogram ordered by Cardiology as needed
  • XR Scoliosis 2 VW Frontal/lat no brace
  • Entire spine MRI w/o contrast
Laboratory
  • CBC no diff
  • Vitamin D 25 OH
  • Type and screen
  • CBC no diff
  • Type and screen
Consults
  • Standard consults (preferably CTIS members)
    • Orthopedics
    • Pulmonary
    • Anesthesia
    • Physical therapy
    • General Surgery
  • Other subspecialists as indicated
Subspecialists as indicated
Respiratory Assessment
  • Stability of ventilatory support
  • Presence of parenchymal disease
  • Optimize airway clearance

 

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