| Pediatric cardiac emergencies. | |
| | |
MedLine Citation:
|
PMID: 11469066 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Successful management of pediatric cardiac emergencies requires an accurate diagnosis to institute an appropriate plan of therapy. The diagnosis, however, is not always straightforward, as evidenced by the nonspecific clinical picture that can be presented by congenital heart defects. Entertaining the possibility of a cardiac problem in neonates with pulmonary symptoms unresponsive to standard therapies is crucial for successful management of patients with congenital heart disease. In addition to ventilatory support, prostaglandin E1 infusions or emergency interventional cardiac catheterization is often a life-saving initial measure in patients with acutely decompensated congenital cardiac lesions that require a patent ductus arteriosus for survival. Pericardial tamponade is associated with various acquired and iatrogenic causes. Emergent pericardiocentesis is mandatory when cardiovascular compromise occurs. The goal of anesthetic management is to maintain cardiac output. With the increasing use of central venous catheters in neonatal ICUs and the high mortality rate for central venous catheter-related cardiac tamponade, the diagnosis must be considered in any patient with a central venous catheter in situ who acutely develops unexplained hypotension, bradycardia, and diminished pulses. Arrhythmias also can cause hemodynamic instability in infants and children. Supraventricular tachycardia is by far the most common emergently presenting arrhythmia in the pediatric population. Unstable patients require immediate intravenous adenosine or synchronized cardioversion. Complete heart block is rare, but it can lead to congestive heart failure and occasionally to cardiovascular collapse and sudden death. Emergency treatment of complete heart block includes pharmacologic support and temporary or permanent pacemaker placement as indicated. In infants, congestive heart failure usually is related to congenital heart disease, whereas in older children, it tends to be secondary to an acquired cause. Supportive measures, fluid restriction, and inotropic support are the principles of initial treatment. Prompt recognition and initiation of appropriate therapy in pediatric cardiac emergencies are essential for favorable outcomes. |
| | |
Authors:
|
C Lee; L J Mason |
Related Documents
:
|
10202196 - The contributions of carl ludwig to cardiology. 2131856 - Noninvasive versus invasive assessment of cardiac output after cardiac surgery: clinica... 16027646 - Fatal cardiac tamponade in a patient with kawasaki disease. 8921646 - Metastatic colonic carcinoma with intracavitary right ventricular outflow tract obstruc... 300216 - Aortic stenosis, angina pectoris, and coronary artery disease. 21546606 - Insulin-like growth factor-1 receptor identifies a pool of human cardiac stem cells wit... |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Anesthesiology clinics of North America Volume: 19 ISSN: 0889-8537 ISO Abbreviation: Anesthesiol Clin North America Publication Date: 2001 Jun |
Date Detail:
|
Created Date: 2001-07-25 Completed Date: 2001-12-07 Revised Date: 2005-11-16 |
Medline Journal Info:
|
Nlm Unique ID: 8810131 Medline TA: Anesthesiol Clin North America Country: United States |
Other Details:
|
Languages: eng Pagination: 287-308 Citation Subset: IM |
Affiliation:
|
Department of Anesthesiology, Loma Linda University, Loma Linda, California, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Anesthesia* Child Emergency Medical Services* Heart Diseases / therapy* Humans |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Neonatal surgical emergencies.
Next Document: Pediatric trauma. Anesthesia management.