Instructions for use: Ikus - Berlin Heart

Antibiotic therapy
Intensive care and aftercare
9.2.1 Example: Platelet aggregation inhibition therapy - Adolescents/adults
Platelet aggregation inhibition
The required daily dose of the platelet aggregation inhibitor acetylsalicylic acid (Aspirin ® ,
75 to 500 mg/d, p.o.) is divided into two daily doses (morning and evening) to
counteract the strong thrombocyte neoformation.
Sufficient inhibition by Aspirin ® is achieved if, in the platelet aggregation test,
arachidonic acid is reduced to < 30% and epinephrine to 40-50%.
Platelet adhesion inhibition
At a thrombocyte count of > 150,000/μl and/or higher amplitude in thromboelastography
(> 80mm): Start of administration of the platelet adhesion inhibitor dipyridamol (150 to
600 mg/d).
9.2.2 Example: Platelet aggregation inhibition therapy - EXCOR Pediatric
Platelet aggregation inhibition
The required daily dose of the platelet aggregation inhibitor acetylsalicylic acid (Aspirin ® ,
initial dose 1 mg/kg/d, p.o.) is divided into two daily doses (morning and evening) to
counteract the strong thrombocyte neoformation.
Sufficient inhibition by Aspirin ® is achieved if, in the platelet aggregation test,
arachidonic acid is reduced to < 30% and epinephrine to 40-50%.
Platelet adhesion inhibition
At a thrombocyte count of > 150,000/μl and/or higher amplitude in thromboelastography
(> 80mm): Start of administration of the platelet adhesion inhibitor dipyridamol
(4 mg/kg/d).
9.3 Antibiotic therapy
Recommendation
• Perform the therapy over 7 days.
• A perioperative antibiotic prophylaxis with good staphylococcus coverage
(e.g. cephalosporin, 2nd generation).
• In the event of signs of local infection in the area of the transcutaneous passage or
evidence of systemic infection: targeted antibiotic therapy after pathogen isolation in all
accessible media (hemoculture, swab).
• In the event of a cannula infection, perform a long-term oral antibiotic therapy, because
otherwise repeated infection flareups may occur.
9.4 Wound care
The incision wound sites must be treated like open wounds. Wound care should be
performed in the inpatient area, and always by the same person. If the patient is
discharged to outpatient care, the patient and family members must be instructed
accordingly. The risk of infection can only be minimized by practicing careful wound care.
Cautionary measure
• For wound care, wear sterile disposable gloves, hood and face mask.
Material (for biventricular access):
• 1 pair of disposable gloves
• 1 hood
• 1 sterile face mask
• 1 pair of sterile disposable gloves
• 1 sterile drape (75x90 cm)
• Disinfectant according to prescription
• 8 sterile-packaged wound plasters (approx. 7x5 cm)
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