STABLEize vs CSWG App

In addition to The S.T.A.B.L.E. Program Module Guidelines: Sugar, Temperature, Airway, Blood pressure, Lab work, Emotional support for the family, this app includes a BONUS menu of 22 severe cardiac anomalies to increase understanding of how blood flows through the heart in the setting of ductal dependent and not ductal dependent congenital heart disease (CHD). - 4 calculators: corrected gestational age, temperature converter (Fahrenheit to Celsius and vice-versa), umbilical artery and venous catheter insertion depth, weight converter (grams to pounds/ounces and vice-versa). - Under Cardiac Anomalies you’ll find animations and information on 22 severe forms of congenital heart disease. The MP4 videos demonstrate how blood flows through the heart with the various forms of CHD, and for ductal-dependent lesions, the severe impact of ductal closure on blood flow. Other animations feature normal heart anatomy, hypercyanotic (tet) spell, and balloon atrial septostomy (Rashkind procedure). Also included are illustrations of palliative procedures (PDA stent, balloon valvuloplasty, BT shunt, RVOT stent, central shunt, pulmonary artery band). STABLE stands for the 6 assessment and care modules in the program: Sugar, Temperature, Airway, BP, Lab work, Emotional support. This app includes the following items: - Sugar module: General Guidelines for sick infants and infants at increased risk for hypoglycemia, IV treatment of a blood sugar less than 50 mg/dL (2.8 mmol/L), useful information about umbilical catheters and actions to correct umbilical artery catheter malpositions. - Temperature module: General Guidelines (hypothermic classifications, monitoring, rewarming after accidental hypothermia), and neuroprotective hypothermia checklist and neurologic exam. - Airway module: monitoring guidelines, respiratory distress descriptions, endotracheal tube sizes and insertion depth, blood gas evaluation, signs of a pneumothorax, and treatment of a pneumothorax. - Blood pressure module: assessment for shock and treatment of shock, including how to mix dopamine hydrochloride to constitute an 800 microgram/mL IV fluid solution. - Lab work module: risk factors for neonatal infection, clinical signs of infection, and laboratory evaluation prior to transport to an intensive care unit. How to calculate the absolute neutrophil count and immature to total ratio. - Emotional support for the family module: the various emotions that parents may be experiencing and how to help families who are experiencing the crisis of a sick newborn. The Cardiac Anomalies menu includes short descriptions and MP4 videos and illustrations for: - Normal Heart and Lungs - Aortic Valve Stenosis - Atrial septal defect - Atrioventricular canal - Coarctation of aorta - Double outlet right ventricle - Ebstein anomaly - Hypoplastic left heart syndrome - Interrupted aortic arch – type B - Patent ductus arteriosus - Pulmonary atresia with intact ventricular septum (IVS) - Pulmonary atresia with IVS and sinusoids - Pulmonary atresia with ventricular septal defect - Total anomalous pulmonary venous connection (TAPVC) – Cardiac, Supracardiac, Infracardiac) - Tetralogy of Fallot (moderate stenosis) - Tetralogy of Fallot (ductal dependent) - Transposition of the Great Arteries - Tricuspid atresia - Truncus arteriosus - Ventricular septal defect Includes illustrations of palliative procedures: balloon atrial septostomy (Rashkind procedure), PDA stent, balloon valvuloplasty, Blalock-Taussig (BT) shunt, right ventricular outflow tract (RVOT) stent, central shunt, pulmonary artery band.

The CSWG App is a comprehensive tool with three distinct parts and provides valuable calculators to assist clinical decision-making. Part 1: Cardiogenic Shock Working Group Shock Stage Calculator The first page of the app features the Cardiogenic Shock Working Group Shock Stage Calculator. This calculator utilizes the CSWG-SCAI shock stage classification system to determine the severity of cardiogenic shock. It provides an accurate assessment of the shock stage, along with the predicted mortality rate for each stage. Additionally, the calculator presents separate mortality predictions for myocardial infarction-related cardiogenic shock (MI-CS) and heart failure-related cardiogenic shock (HF-CS). Furthermore, it offers a predicted probability of stage escalation. Part 2: Invasive Hemodynamics Calculator The second page of the app houses the Invasive Hemodynamics Calculator. This powerful tool enables healthcare professionals to calculate various important parameters related to hemodynamics. With this calculator, users can determine parameters such as cardiac output using the Fick method, cardiac index, cardiac power output, cardiac power index, pulse pressure, aortic pulsatility index, systemic vascular resistance, mean pulmonary artery pressure, right atrial pressure/pulmonary capillary wedge pressure, pulmonary artery pulsatility index, right ventricular stroke work index, transpulmonary gradient, and diastolic pulmonary gradient. Additionally, the calculator generates a graph that plots left heart filling pressure (PCWP) and right heart filling pressure (CVP or RAP) to aid in the classification of parameters into categories such as "LV congestion," "RV congestion," "Hypovolemic," and "BiV Congestion." Part 3:Congestion Profile Tracking Plot left heart filling pressure (PCWP) and right heart filling pressure (CVP or RAP) to aid in the classification of parameters into categories such as "LV congestion," "RV congestion," "Hypovolemic," and "BiV Congestion." Plot points longitudinally to see trends over time. Part 4: CSWG-SCAI Shock Phenotype Calculator The final part of the app is the CSWG-SCAI Shock Phenotype Calculator. This calculator is designed to determine the shock phenotype based on specific characteristics and clinical indicators. It classifies the shock phenotype into three categories: phenotype I (non-congested), phenotype II (cardio-renal), and phenotype III (cardiometabolic). Additionally, the calculator provides a predicted in-hospital mortality rate for each phenotype, aiding clinicians in risk stratification and treatment planning. The CSWG App for iOS consolidates essential calculators and predictive capabilities in a user-friendly interface, offering a valuable resource for healthcare professionals involved in the management of cardiogenic shock. By facilitating accurate assessments, providing hemodynamic insights, and assisting in the determination of shock phenotypes, this app aims to optimize patient care and outcomes in the challenging context of cardiogenic shock. Please note that this app only presents data published in the literature and should not be a substitute for clinical decision making. The treating clinician/team should use their judgement and experience in clinical decision making.