Sebastian Roby, Ullah Sana, Motta Pablo, Das Bibhuti, Zabala Luis
Department of Anesthesiology and Pain Management, 248024University of Texas Southwestern, Dallas, TX, USA.
Children's Medical Center of Dallas, Anesthesiology and Pain Management, Dallas, TX, USA.
Semin Cardiothorac Vasc Anesth. 2022 Mar;26(1):41-53. doi: 10.1177/10892532211044977. Epub 2021 Nov 3.
Acute decompensated heart failure (ADHF) in pediatrics is a significant cause for morbidity and mortality in children. Congenital heart disease and cardiomyopathy are the leading etiologies of ADHF. It is common for these children to undergo diagnostic, therapeutic, or surgical procedure under anesthesia, which may be associated with significant morbidity and mortality. The importance of preanesthetic multidisciplinary planning with all involved teams, including anesthesia, cardiology, intensive care, perfusion, and cardiac surgery, cannot be emphasized enough. In order to safely manage these patients, it is imperative for the anesthesiologist to understand the complex pathophysiological interactions between cardiopulmonary systems and anesthesia during these procedures. This review discusses the etiology, pathophysiology, clinical manifestations, and perioperative management of these patients.
小儿急性失代偿性心力衰竭（ADHF）是儿童发病和死亡的重要原因。先天性心脏病和心肌病是ADHF的主要病因。这些患儿常在麻醉下接受诊断、治疗或外科手术，这可能会带来显著的发病率和死亡率。术前多学科规划，包括麻醉、心脏病学、重症监护、体外循环灌注和心脏外科等所有相关团队的参与，其重要性无论怎么强调都不为过。为了安全地管理这些患者，麻醉医生必须了解这些手术过程中心肺系统与麻醉之间复杂的病理生理相互作用。本综述讨论了这些患者的病因、病理生理学、临床表现和围手术期管理。
