SlideShare uma empresa Scribd logo
1 de 91
CHILDREN WITH CONGENITAL HEART DISEASE George Nicolaou, MD FRCPC Department of Anesthesia  & Perioperative Medicine University of Western Ontario http://www.childrensheartinstitute.org ANESTHESIA FOR
INTRODUCTION ,[object Object],[object Object],[object Object]
INCIDENCE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ETIOLOGY ,[object Object],[object Object],[object Object],[object Object],[object Object]
FETAL CIRCULATION ,[object Object],[object Object]
CARDIOPULMONARY CHANGES AT BIRTH ,[object Object],[object Object],[object Object]
CARDIOPULMONARY CHANGES AT BIRTH ,[object Object]
CARDIOPULMONARY CHANGES AT BIRTH ,[object Object],[object Object],[object Object],[object Object],[object Object]
CARDIOPULMONARY CHANGES AT BIRTH ,[object Object],[object Object],[object Object]
CLASSIFICATION OF CHD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CLASSIFICATION OF CHD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
VENTRICULAR SEPTAL DEFECT
ATRIOVENTRICULAR CANAL DEFECT
L – R SHUNTS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CLASSIFICATION OF CHD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
R – L SHUNTS ,[object Object],[object Object],[object Object],[object Object]
GLENN SHUNT
MODIFIED BLALOCK-TAUSSIG SHUNT
TETRALOGY OF FALLOT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TETRALOGY OF FALLOT
TETRALOGY OF FALLOT ,[object Object],[object Object],[object Object],[object Object]
TETRALOGY OF FALLOT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TETRALOGY OF FALLOT ,[object Object],[object Object],[object Object],[object Object],[object Object]
EBSTEIN’S ANOMALY
CLASSIFICATION OF CHD ,[object Object],[object Object],[object Object],[object Object],[object Object]
CLASSIFICATION OF CHD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
TOTAL ANOMALOUS PULMONARY VENOUS RETURN
TOTAL ANOMALOUS PULMONARY VENOUS RETURN
HYPOPLASTIC LEFT HEART SYNDROME
TRANSPOSITION OF GREAT VESSELS
TRUNCUS ARTERIOSUS
DOUBLE OUTLET RIGHT VENTRICLE
FONTAN PROCEDURE
NORWOOD PROCEDURE
JATENE PROCEDURE
CLASSIFICATION OF CHD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CLASSIFICATION OF CHD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COARCTATION OF AORTA
COARCTATION OF AORTA
INTERUPTION OF AORTIC ARCH
COR TRIATIATUM
CLASSIFICATION OF CHD
CLASSIFICATION OF CHD
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],Anesthesiologists will encounter children with CHD for elective non-cardiac surgery at one of three stages:
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HISTORY & PHYSICAL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HISTORY & PHYSICAL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LABORATORY EVALUATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LABORATORY EVALUATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LABORATORY EVALUATION ,[object Object],[object Object],[object Object],[object Object]
LABORATORY EVALUATION ,[object Object],[object Object],[object Object],[object Object],[object Object]
LABORATORY EVALUATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LABORATORY EVALUATION ,[object Object],[object Object],[object Object],[object Object]
PREMEDICATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PREMEDICATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MONITORING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MONITORING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANESTHETIC AGENTS ,[object Object],[object Object],[object Object],[object Object]
INHALATIONAL ANESTHETICS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INHALATIONAL ANESTHETICS ,[object Object],[object Object],[object Object],[object Object],[object Object]
INHALATIONAL ANESTHETICS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INHALATIONAL ANESTHETICS ,[object Object],[object Object],[object Object],[object Object],[object Object]
INHALATIONAL ANESTHETICS ,[object Object],[object Object],[object Object],[object Object]
INHALATIONAL ANESTHETICS ,[object Object],[object Object],[object Object],[object Object]
IM & IV ANESTHETICS ,[object Object],[object Object],[object Object],[object Object],[object Object]
IM & IV ANESTHETICS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IM & IV ANESTHETICS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IM & IV ANESTHETICS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IM & IV ANESTHETICS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object]
ANESTHESIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object]
ANESTHETIC MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object]
REGIONAL ANESTHESIA &ANALGESIA ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],REGIONAL ANESTHESIA &ANALGESIA ,[object Object]
POSTOPERATIVE MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],POSTOPERATIVE MANAGEMENT

Mais conteúdo relacionado

Mais procurados

Valvular Heart Disease & Anaesthetic Implications
Valvular Heart Disease & Anaesthetic ImplicationsValvular Heart Disease & Anaesthetic Implications
Valvular Heart Disease & Anaesthetic ImplicationsDr.Daber Pareed
 
Anaesthesia for children with chd (2)
Anaesthesia for children with chd (2)Anaesthesia for children with chd (2)
Anaesthesia for children with chd (2)Ashraf Abdulhalim
 
Anaesthetic management of a case of valvular heart disease... final
Anaesthetic management of a case of valvular heart disease... finalAnaesthetic management of a case of valvular heart disease... final
Anaesthetic management of a case of valvular heart disease... finalDr Ravi Shankar Sharma
 
Perioperative Arrythmias and management
Perioperative Arrythmias and managementPerioperative Arrythmias and management
Perioperative Arrythmias and managementDr Nandini Deshpande
 
Anesthesia Management in Aortic Regurgitation
Anesthesia Management in Aortic RegurgitationAnesthesia Management in Aortic Regurgitation
Anesthesia Management in Aortic RegurgitationDr. Harshil Joshi
 
Pregnancy with mitral stenosis final
Pregnancy with mitral stenosis finalPregnancy with mitral stenosis final
Pregnancy with mitral stenosis finalanaesthesiaESICMCH
 
Ischemic heart disease and anesthetic management
Ischemic heart disease and anesthetic managementIschemic heart disease and anesthetic management
Ischemic heart disease and anesthetic managementkrishna dhakal
 
Transesophageal echocardiography
Transesophageal echocardiographyTransesophageal echocardiography
Transesophageal echocardiographyNeeraj Varyani
 
ANESTHESIA FOR CONGENITAL HEART DISEASES
ANESTHESIA FOR CONGENITAL HEART DISEASES ANESTHESIA FOR CONGENITAL HEART DISEASES
ANESTHESIA FOR CONGENITAL HEART DISEASES Ali Mahareak
 
Transesophageal echocardiography
Transesophageal echocardiographyTransesophageal echocardiography
Transesophageal echocardiographyAmit Gulati
 
Perioperative myocardial infarction ppt
Perioperative myocardial infarction pptPerioperative myocardial infarction ppt
Perioperative myocardial infarction pptYogasundaram Sasikumar
 
Rational choice of inotropes and vasopressors in intensive care unit
Rational choice of inotropes and vasopressors in intensive care unitRational choice of inotropes and vasopressors in intensive care unit
Rational choice of inotropes and vasopressors in intensive care unitSaneesh P J
 
Deep hypothermic circulatory arrest in pediatric cardiac sur
Deep hypothermic circulatory arrest in pediatric cardiac surDeep hypothermic circulatory arrest in pediatric cardiac sur
Deep hypothermic circulatory arrest in pediatric cardiac surManu Jacob
 
Cardiovascular physiology for anesthesia
Cardiovascular physiology for anesthesiaCardiovascular physiology for anesthesia
Cardiovascular physiology for anesthesiamarwa Mahrous
 

Mais procurados (20)

Transesophageal echocardiography(TEE)
Transesophageal echocardiography(TEE)Transesophageal echocardiography(TEE)
Transesophageal echocardiography(TEE)
 
Valvular Heart Disease & Anaesthetic Implications
Valvular Heart Disease & Anaesthetic ImplicationsValvular Heart Disease & Anaesthetic Implications
Valvular Heart Disease & Anaesthetic Implications
 
Anaesthesia for children with chd (2)
Anaesthesia for children with chd (2)Anaesthesia for children with chd (2)
Anaesthesia for children with chd (2)
 
Cardioplegia
CardioplegiaCardioplegia
Cardioplegia
 
Anaesthetic management of a case of valvular heart disease... final
Anaesthetic management of a case of valvular heart disease... finalAnaesthetic management of a case of valvular heart disease... final
Anaesthetic management of a case of valvular heart disease... final
 
Perioperative Arrythmias and management
Perioperative Arrythmias and managementPerioperative Arrythmias and management
Perioperative Arrythmias and management
 
Anesthesia Management in Aortic Regurgitation
Anesthesia Management in Aortic RegurgitationAnesthesia Management in Aortic Regurgitation
Anesthesia Management in Aortic Regurgitation
 
Pregnancy with mitral stenosis final
Pregnancy with mitral stenosis finalPregnancy with mitral stenosis final
Pregnancy with mitral stenosis final
 
Ischemic preconditioning
Ischemic preconditioningIschemic preconditioning
Ischemic preconditioning
 
Peri operative arrhyth
Peri operative arrhythPeri operative arrhyth
Peri operative arrhyth
 
Ischemic heart disease and anesthetic management
Ischemic heart disease and anesthetic managementIschemic heart disease and anesthetic management
Ischemic heart disease and anesthetic management
 
Transesophageal echocardiography
Transesophageal echocardiographyTransesophageal echocardiography
Transesophageal echocardiography
 
ANESTHESIA FOR CONGENITAL HEART DISEASES
ANESTHESIA FOR CONGENITAL HEART DISEASES ANESTHESIA FOR CONGENITAL HEART DISEASES
ANESTHESIA FOR CONGENITAL HEART DISEASES
 
Transesophageal echocardiography
Transesophageal echocardiographyTransesophageal echocardiography
Transesophageal echocardiography
 
Perioperative myocardial infarction ppt
Perioperative myocardial infarction pptPerioperative myocardial infarction ppt
Perioperative myocardial infarction ppt
 
Rational choice of inotropes and vasopressors in intensive care unit
Rational choice of inotropes and vasopressors in intensive care unitRational choice of inotropes and vasopressors in intensive care unit
Rational choice of inotropes and vasopressors in intensive care unit
 
Diastolic dysfunction
Diastolic dysfunctionDiastolic dysfunction
Diastolic dysfunction
 
Deep hypothermic circulatory arrest in pediatric cardiac sur
Deep hypothermic circulatory arrest in pediatric cardiac surDeep hypothermic circulatory arrest in pediatric cardiac sur
Deep hypothermic circulatory arrest in pediatric cardiac sur
 
Cardiovascular physiology for anesthesia
Cardiovascular physiology for anesthesiaCardiovascular physiology for anesthesia
Cardiovascular physiology for anesthesia
 
Mitral stenosis and Anesthesia
Mitral stenosis and AnesthesiaMitral stenosis and Anesthesia
Mitral stenosis and Anesthesia
 

Semelhante a Anesthesia For Children With Congenital Heart Disease1

Ebstein’s anomaly & Truncus Arteriosus
Ebstein’s anomaly & Truncus ArteriosusEbstein’s anomaly & Truncus Arteriosus
Ebstein’s anomaly & Truncus ArteriosusTarun Bhatnagar
 
Ebstein’s anomaly & Truncus Arteriosus
Ebstein’s anomaly & Truncus ArteriosusEbstein’s anomaly & Truncus Arteriosus
Ebstein’s anomaly & Truncus ArteriosusTarun Bhatnagar
 
Congenital Heart Defects
Congenital Heart DefectsCongenital Heart Defects
Congenital Heart Defectsdapinderjitgill
 
Seminar on Congenital Heart Disease
Seminar on Congenital Heart DiseaseSeminar on Congenital Heart Disease
Seminar on Congenital Heart DiseaseSoumen Sengupta
 
Pulmonary hypertension and the Intensivist
Pulmonary hypertension and the IntensivistPulmonary hypertension and the Intensivist
Pulmonary hypertension and the IntensivistAndrew Ferguson
 
Anesthesia for Congenital Heart Disease By Desta Oli.pptx
Anesthesia for Congenital Heart Disease By Desta Oli.pptxAnesthesia for Congenital Heart Disease By Desta Oli.pptx
Anesthesia for Congenital Heart Disease By Desta Oli.pptxDesta Oli
 
Anesthesia for Congenital Heart Disease By Desta Oli.pptx
Anesthesia for Congenital Heart Disease By Desta Oli.pptxAnesthesia for Congenital Heart Disease By Desta Oli.pptx
Anesthesia for Congenital Heart Disease By Desta Oli.pptxDesta Oli
 
Desta-Oli-Waktasu.pptx-pediatrics
Desta-Oli-Waktasu.pptx-pediatricsDesta-Oli-Waktasu.pptx-pediatrics
Desta-Oli-Waktasu.pptx-pediatricsDesta Oli
 
Complete transposition of the great arteries (D-TGA.pptx
Complete transposition of the great arteries (D-TGA.pptxComplete transposition of the great arteries (D-TGA.pptx
Complete transposition of the great arteries (D-TGA.pptxDrPNatarajan2
 
Congenital heart disease
Congenital heart diseaseCongenital heart disease
Congenital heart diseasegaganbrar18
 
pediatrics congenital heart disease
pediatrics congenital heart diseasepediatrics congenital heart disease
pediatrics congenital heart diseasegetandale zeleke
 
Congenital cyanotic heart disease approach
Congenital cyanotic heart disease approachCongenital cyanotic heart disease approach
Congenital cyanotic heart disease approachVarsha Shah
 
Congenital heart disease
Congenital heart diseaseCongenital heart disease
Congenital heart diseaseKiran Rajagopal
 
Acyanotic Heart Disease
Acyanotic Heart DiseaseAcyanotic Heart Disease
Acyanotic Heart Diseaseguest896d22f
 

Semelhante a Anesthesia For Children With Congenital Heart Disease1 (20)

Ebstein’s anomaly & Truncus Arteriosus
Ebstein’s anomaly & Truncus ArteriosusEbstein’s anomaly & Truncus Arteriosus
Ebstein’s anomaly & Truncus Arteriosus
 
Ebstein’s anomaly & Truncus Arteriosus
Ebstein’s anomaly & Truncus ArteriosusEbstein’s anomaly & Truncus Arteriosus
Ebstein’s anomaly & Truncus Arteriosus
 
congenital heart disease
congenital heart diseasecongenital heart disease
congenital heart disease
 
Congenital Heart Defects
Congenital Heart DefectsCongenital Heart Defects
Congenital Heart Defects
 
Asd and vsd
Asd and vsdAsd and vsd
Asd and vsd
 
Seminar on Congenital Heart Disease
Seminar on Congenital Heart DiseaseSeminar on Congenital Heart Disease
Seminar on Congenital Heart Disease
 
Pulmonary hypertension and the Intensivist
Pulmonary hypertension and the IntensivistPulmonary hypertension and the Intensivist
Pulmonary hypertension and the Intensivist
 
Anesthesia for Congenital Heart Disease By Desta Oli.pptx
Anesthesia for Congenital Heart Disease By Desta Oli.pptxAnesthesia for Congenital Heart Disease By Desta Oli.pptx
Anesthesia for Congenital Heart Disease By Desta Oli.pptx
 
Anesthesia for Congenital Heart Disease By Desta Oli.pptx
Anesthesia for Congenital Heart Disease By Desta Oli.pptxAnesthesia for Congenital Heart Disease By Desta Oli.pptx
Anesthesia for Congenital Heart Disease By Desta Oli.pptx
 
Desta-Oli-Waktasu.pptx-pediatrics
Desta-Oli-Waktasu.pptx-pediatricsDesta-Oli-Waktasu.pptx-pediatrics
Desta-Oli-Waktasu.pptx-pediatrics
 
Complete transposition of the great arteries (D-TGA.pptx
Complete transposition of the great arteries (D-TGA.pptxComplete transposition of the great arteries (D-TGA.pptx
Complete transposition of the great arteries (D-TGA.pptx
 
Cyanotic Heart Disease
Cyanotic Heart DiseaseCyanotic Heart Disease
Cyanotic Heart Disease
 
Congenital heart disease
Congenital heart diseaseCongenital heart disease
Congenital heart disease
 
Valvular heart disease and anaesthesia
Valvular heart disease and anaesthesiaValvular heart disease and anaesthesia
Valvular heart disease and anaesthesia
 
An approach to a patient with ventricular septal defect
An approach to a patient with ventricular septal defect An approach to a patient with ventricular septal defect
An approach to a patient with ventricular septal defect
 
pediatrics congenital heart disease
pediatrics congenital heart diseasepediatrics congenital heart disease
pediatrics congenital heart disease
 
Congenital cyanotic heart disease approach
Congenital cyanotic heart disease approachCongenital cyanotic heart disease approach
Congenital cyanotic heart disease approach
 
Uremic Pericarditis
Uremic PericarditisUremic Pericarditis
Uremic Pericarditis
 
Congenital heart disease
Congenital heart diseaseCongenital heart disease
Congenital heart disease
 
Acyanotic Heart Disease
Acyanotic Heart DiseaseAcyanotic Heart Disease
Acyanotic Heart Disease
 

Mais de Ahmed Shalabi

Oligofructose Prebiotics
Oligofructose PrebioticsOligofructose Prebiotics
Oligofructose PrebioticsAhmed Shalabi
 
Drug Chirality In Anesthesia.29
Drug  Chirality In  Anesthesia.29Drug  Chirality In  Anesthesia.29
Drug Chirality In Anesthesia.29Ahmed Shalabi
 
H T N Emergency In Aortic Aneurysm
H T N Emergency In Aortic AneurysmH T N Emergency In Aortic Aneurysm
H T N Emergency In Aortic AneurysmAhmed Shalabi
 
Anesthetic Effects On The Fetus And Newborn
Anesthetic  Effects On The  Fetus And  NewbornAnesthetic  Effects On The  Fetus And  Newborn
Anesthetic Effects On The Fetus And NewbornAhmed Shalabi
 
Protocol For Endovasc Repair Of Rupture A A
Protocol For Endovasc Repair Of Rupture  A AProtocol For Endovasc Repair Of Rupture  A A
Protocol For Endovasc Repair Of Rupture A AAhmed Shalabi
 
Ketamine In Emergency
Ketamine In EmergencyKetamine In Emergency
Ketamine In EmergencyAhmed Shalabi
 
perioperative management Pacemaker Insertion In Congenital Heart
perioperative management Pacemaker Insertion In Congenital Heartperioperative management Pacemaker Insertion In Congenital Heart
perioperative management Pacemaker Insertion In Congenital HeartAhmed Shalabi
 
Anesthesia And Congenital Heart Disease
Anesthesia And Congenital Heart DiseaseAnesthesia And Congenital Heart Disease
Anesthesia And Congenital Heart DiseaseAhmed Shalabi
 
Non Cardiac Surgery For Adults With Congenital Heart
Non Cardiac Surgery For Adults With Congenital HeartNon Cardiac Surgery For Adults With Congenital Heart
Non Cardiac Surgery For Adults With Congenital HeartAhmed Shalabi
 
Sepsis 2008 Pocket Guidelines
Sepsis 2008  Pocket  GuidelinesSepsis 2008  Pocket  Guidelines
Sepsis 2008 Pocket GuidelinesAhmed Shalabi
 
Low Cardiac Output Synd
Low Cardiac Output SyndLow Cardiac Output Synd
Low Cardiac Output SyndAhmed Shalabi
 
Low Cardiac Output Synd
Low Cardiac Output SyndLow Cardiac Output Synd
Low Cardiac Output SyndAhmed Shalabi
 
Perioperative Critical Care Cardiology
Perioperative  Critical  Care  CardiologyPerioperative  Critical  Care  Cardiology
Perioperative Critical Care CardiologyAhmed Shalabi
 

Mais de Ahmed Shalabi (13)

Oligofructose Prebiotics
Oligofructose PrebioticsOligofructose Prebiotics
Oligofructose Prebiotics
 
Drug Chirality In Anesthesia.29
Drug  Chirality In  Anesthesia.29Drug  Chirality In  Anesthesia.29
Drug Chirality In Anesthesia.29
 
H T N Emergency In Aortic Aneurysm
H T N Emergency In Aortic AneurysmH T N Emergency In Aortic Aneurysm
H T N Emergency In Aortic Aneurysm
 
Anesthetic Effects On The Fetus And Newborn
Anesthetic  Effects On The  Fetus And  NewbornAnesthetic  Effects On The  Fetus And  Newborn
Anesthetic Effects On The Fetus And Newborn
 
Protocol For Endovasc Repair Of Rupture A A
Protocol For Endovasc Repair Of Rupture  A AProtocol For Endovasc Repair Of Rupture  A A
Protocol For Endovasc Repair Of Rupture A A
 
Ketamine In Emergency
Ketamine In EmergencyKetamine In Emergency
Ketamine In Emergency
 
perioperative management Pacemaker Insertion In Congenital Heart
perioperative management Pacemaker Insertion In Congenital Heartperioperative management Pacemaker Insertion In Congenital Heart
perioperative management Pacemaker Insertion In Congenital Heart
 
Anesthesia And Congenital Heart Disease
Anesthesia And Congenital Heart DiseaseAnesthesia And Congenital Heart Disease
Anesthesia And Congenital Heart Disease
 
Non Cardiac Surgery For Adults With Congenital Heart
Non Cardiac Surgery For Adults With Congenital HeartNon Cardiac Surgery For Adults With Congenital Heart
Non Cardiac Surgery For Adults With Congenital Heart
 
Sepsis 2008 Pocket Guidelines
Sepsis 2008  Pocket  GuidelinesSepsis 2008  Pocket  Guidelines
Sepsis 2008 Pocket Guidelines
 
Low Cardiac Output Synd
Low Cardiac Output SyndLow Cardiac Output Synd
Low Cardiac Output Synd
 
Low Cardiac Output Synd
Low Cardiac Output SyndLow Cardiac Output Synd
Low Cardiac Output Synd
 
Perioperative Critical Care Cardiology
Perioperative  Critical  Care  CardiologyPerioperative  Critical  Care  Cardiology
Perioperative Critical Care Cardiology
 

Último

O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadO898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadGENUINE ESCORT AGENCY
 
Call Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Dipal Arora
 
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...aartirawatdelhi
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...astropune
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...hotbabesbook
 
Call Girls Siliguri Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...narwatsonia7
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Ishani Gupta
 
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...Dipal Arora
 
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur  Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Guntur  Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...astropune
 
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 

Último (20)

O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadO898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Call Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service Available
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
 
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
Call Girls Siliguri Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 8250077686 Top Class Call Girl Service Available
 
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
 
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
 
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur  Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Guntur  Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
 
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
 

Anesthesia For Children With Congenital Heart Disease1