Anaesthetic management of children with congenital heart disease for non-cardiac surgery

White, Michelle; Peyton, James

doi:10.1093/bjaceaccp/mkr049

Cited by 43 publications

(64 citation statements)

References 14 publications

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“…Dentro de las condiciones más complejas y que presumiblemente tendrás más eventos hemodinámicos desfavorables se encuentran los pacientes portadores de ventrículo único 3 , especialmente en la etapa I, los pacientes con obstrucción del tracto de salida ventricular y pacientes con cardiomiopatía. Las condiciones de menos riesgo son felizmente las más frecuentes y corresponden a los pacientes que presentan cortocircuito de izquierda a derecha.…”

Section: ¿Por Qúe Los Anestesiólogos Generales Necesitamos Saber De Cc?unclassified

“…Esta información se encuentra normalmente en la ecocardiografía más reciente tanto si el paciente aún no ha sido intervenido, como si se encuentra con la cardiopatía corregida o ha recibido una cirugía paliativa. Si existe una duda sobre la condición cardiológica es conveniente consultar al cardiólogo de cabecera 3 . A continuación se exhibe una clasificación operacional para el no especialista.…”

Section: ¿Por Qúe Los Anestesiólogos Generales Necesitamos Saber De Cc?unclassified

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Anestesia para cirugía no cardíaca en pacientes pediátricos portadores de cardiopatías congénitas

Cavallieri¹,

Boye²

2017

Rev Chil Anest

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Section: ¿Por Qúe Los Anestesiólogos Generales Necesitamos Saber De Cc?unclassified

Anestesia para cirugía no cardíaca en pacientes pediátricos portadores de cardiopatías congénitas

Cavallieri¹,

Boye²

2017

Rev Chil Anest

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“…3 In addition to complexity and physiological status, other risk factors are type of surgery, age, length of hospital stay before surgery, and ASA physical status IV or V. On the basis of the available evidence, a pragmatic attempt has been made to classify children as high, intermediate and low risk in order to aid management (Table 1). 4 Individual risk factors are discussed below.…”

Section: Risk Classificationmentioning

confidence: 99%

“…total cavopulmonary circulation) IVC centre even for minor procedures. 4,7,8 In the emergency situation children may need retrieval by a specialist transport team. In the rare event of transfer being impossible, advice should be sought from the tertiary centre paediatric cardiology and paediatric cardiac anaesthesia services.…”

Section: Cardiac Failurementioning

confidence: 99%

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Anaesthetic implications of congenital heart disease for children undergoing non-cardiac surgery

Wijesingha¹,

White²

2015

Anaesthesia & Intensive Care Medicine

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Children with congenital heart disease (CHD) are at increased risk of morbidity, perioperative cardiac arrest and 30-day mortality from major and minor surgical procedures compared to healthy children. Factors associated with greatest risk are the complexity of cardiac disease and the physiological status of the child. Therefore the anaesthetist must understand balanced and single ventricle circulations and be able to assess the effects of four major complications of CHD: cardiac failure, arrhythmias, pulmonary hypertension and cyanosis. Other risk factors include type of surgery, age, ASA physical status and length of preoperative hospital stay. Because of the diversity of CHD and the range of surgical procedures a generalized approach to anaesthesia is impossible. Preoperative assessment, induction and maintenance should all be individualized to the child and tailored to the type of surgery. Whether surgery occurs in the local hospital or tertiary cardiac centre depends on risk classification (high, intermediate and low). Some children require full cardiac anaesthesia, intensive care and cardiology support making care in the local hospital inappropriate, whereas for others, care in their local hospital is both safe and convenient.

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Cancer diagnostic profile in children with structural birth defects: An assessment in 15,000 childhood cancer cases

Schraw

Desrosiers

Nembhard

et al. 2020

Cancer

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Background Birth defects are established risk factors for childhood cancer. Nonetheless, cancer epidemiology in children with birth defects is not well characterized. Methods Using data from population‐based registries in 4 US states, this study compared children with cancer but no birth defects (n = 13,111) with children with cancer and 1 or more nonsyndromic birth defects (n = 1616). The objective was to evaluate cancer diagnostic characteristics, including tumor type, age at diagnosis, and stage at diagnosis. Results Compared with the general population of children with cancer, children with birth defects were diagnosed with more embryonal tumors (26.6% vs 18.7%; q < 0.001), including neuroblastoma (12.5% vs 8.2%; q < 0.001) and hepatoblastoma (5.0% vs 1.3%; q < 0.001), but fewer hematologic malignancies, including acute lymphoblastic leukemia (12.4% vs 24.4%; q < 0.001). In age‐stratified analyses, differences in tumor type were evident among children younger than 1 year and children 1 to 4 years old, but they were attenuated among children 5 years of age or older. The age at diagnosis was younger in children with birth defects for most cancers, including leukemia, lymphoma, astrocytoma, medulloblastoma, ependymoma, embryonal tumors, and germ cell tumors (all q < 0.05). Conclusions The results indicate possible etiologic heterogeneity in children with birth defects, have implications for future surveillance efforts, and raise the possibility of differential cancer ascertainment in children with birth defects. Lay Summary Scientific studies suggest that children with birth defects are at increased risk for cancer. However, these studies have not been able to determine whether important tumor characteristics, such as the type of tumor diagnosed, the age at which the tumor is diagnosed, and the degree to which the tumor has spread at the time of diagnosis, are different for children with birth defects and children without birth defects. This study attempts to answer these important questions. By doing so, it may help scientists and physicians to understand the causes of cancer in children with birth defects and diagnose cancer at earlier stages when it is more treatable.

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Anaesthetic management of children with congenital heart disease for non-cardiac surgery

Cited by 43 publications

References 14 publications

Anestesia para cirugía no cardíaca en pacientes pediátricos portadores de cardiopatías congénitas

Anestesia para cirugía no cardíaca en pacientes pediátricos portadores de cardiopatías congénitas

Anaesthetic implications of congenital heart disease for children undergoing non-cardiac surgery

Cancer diagnostic profile in children with structural birth defects: An assessment in 15,000 childhood cancer cases

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