The post-anesthetic care of pediatric patients with pulmonary hypertension

Destiny F. Chau, Meera Gangadharan, Lopa P. Hartke, Mark D. Twite

    Research output: Contribution to journalArticle

    8 Scopus citations

    Abstract

    Few conditions make even the most experienced pediatric anesthesiologists take pause. Pulmonary hypertension is one such condition due to the associated high perioperative morbidity and mortality. Much is written about the intraoperative management of pediatric pulmonary hypertension. This article will instead focus on postoperative care and review the evidence in support of a risk stratification approach for the post-anesthetic disposition of these patients. The total risk for post-anesthetic adverse events includes the patient's baseline risk factors and the incremental risks imposed by the procedure and anesthetic. A proposal with recommendations to guide practitioners and a table summarizing relevant factors are provided. Last, the readers' attention is drawn to the heterogeneity of pulmonary hypertensive disease. Pulmonary arterial hypertension (precapillary) differs significantly from pulmonary venous hypertension (postcapillary); the anesthetic management for one may be relatively contraindicated in the other. Their dissimilarities justify the need to distinguish them for study and research endeavors.

    Original languageEnglish (US)
    Pages (from-to)63-73
    Number of pages11
    JournalSeminars in Cardiothoracic and Vascular Anesthesia
    Volume20
    Issue number1
    DOIs
    StatePublished - Mar 1 2016

    Keywords

    • cardiac anesthesia
    • children
    • hypertension
    • pediatric intensive care
    • perioperative mortality
    • postoperative care
    • postoperative complications
    • pulmonary artery pressure

    ASJC Scopus subject areas

    • Anesthesiology and Pain Medicine
    • Cardiology and Cardiovascular Medicine

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