The Fontan procedure refers to any operation that results in the flow of systemic venous blood to the lungs without passing through a ventricle. Once the procedure is complete the systemic venous blood directly enters the pulmonary circulation, placing the systemic and pulmonary circulations in series driven by a single ventricle. Therefore, the pulmonary vascular resistance (PVR) will control the cardiac output. Continue reading
Neutropenia is common with chemotherapy, nadirs at 7-14 days, and is defined as an absolute neutrophil count (ANC) < 500 cells/μL or < 1,000 cells/μL with a predicted nadir of < 500 cells/μL. Fever in a neutropenic patient is defined as a single temperature greater than 38.3°C (101.3°F) or temperature > 38°C (100.4°F) for > 1 hour. Continue reading
Acute sequestration crisis is caused by obstruction of the splenic sinusoids with sickled cells. It most commonly presents in children between 6 months and 2 years although it has been reported into the early twenties. Signs and symptoms include the rapid onset of fatigue, listlessness, pallor, abdominal pain, and splenomegaly. Infection is a common precipitant and can mask the symptoms. Continue reading
Typhlitis, also known as necrotizing enterocolitis, is a devastating infection that can affect those with hematologic malignancies after receiving chemotherapy. It usually occurs when the patient is neutropenic and the mortality is high. This condition was previously thought to affect only children, but adults have been diagnosed as well. Continue reading
