Education in Heart
Perioperative manipulation of the circulation in children with congenital heart disease
Correspondence to:
Associate Professor Lara Shekerdemian, The Royal Children’s Hospital, Flemington Road, Parkville, Melbourne, VIC 3052, Australia; lara.shekerdemian@rch.org.au
| The first 150 words of the full text of this article appear below. |
A low cardiac output state with reduced systemic oxygen delivery can complicate the early postoperative recovery early after surgery for congenital heart disease (CHD). All patients undergoing surgery on cardiopulmonary bypass (CPB) are at risk for a low cardiac output state, but the risk is greatest for younger patients undergoing more complex surgery. Although the clinical manifestations of a reduced cardiac output are generally transient and reversible, this can result in increased intensive care stay, and contributes to the long term morbidity and mortality associated with surgery for CHD.
The circulatory management of children with CHD should routinely be aimed at optimising systemic oxygen delivery according to the underlying diagnosis and physiology. This article will begin with a review of the pathophysiology of circulatory insufficiency, focusing on the period early after surgery for CHD. This background will provide a template for the ensuing discussions of a range of strategies for
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