Babu Saravana, Sreedhar Rupa, Munaf Mamatha, Gadhinglajkar Shrinivas V
Division of Cardiothoracic and Vascular Anesthesia, Sree Chitra Tirunal institute for medical sciences and technology, Trivandrum, India.
Division of Cardiothoracic and Vascular Anesthesia, Sree Chitra Tirunal institute for medical sciences and technology, Trivandrum, India.
J Cardiothorac Vasc Anesth. 2023 Jun;37(6):1000-1012. doi: 10.1053/j.jvca.2023.02.011. Epub 2023 Feb 11.
Sepsis remains among the most common causes of mortality in children with congenital heart disease (CHD). Extensive literature is available regarding managing sepsis in pediatric patients without CHD. Because the cardiovascular pathophysiology of children with CHD differs entirely from their typical peers, the available diagnosis and management recommendations for sepsis cannot be implemented directly in children with CHD. This review discusses the risk factors, etiopathogenesis, available diagnostic tools, resuscitation protocols, and anesthetic management of pediatric patients suffering from various congenital cardiac lesions. Further research should focus on establishing a standard guideline for managing children with CHD with sepsis and septic shock admitted to the intensive care unit.
脓毒症仍然是先天性心脏病（CHD）患儿最常见的死亡原因之一。关于无CHD的儿科患者脓毒症的管理，有大量文献可供参考。由于CHD患儿的心血管病理生理学与正常同龄人完全不同，现有的脓毒症诊断和管理建议不能直接应用于CHD患儿。本综述讨论了患有各种先天性心脏病变的儿科患者的危险因素、病因发病机制、可用的诊断工具、复苏方案和麻醉管理。进一步的研究应侧重于制定针对入住重症监护病房的CHD合并脓毒症和感染性休克患儿的管理标准指南。
