RESUMEN
Children with suspected pulmonary hypertension must undergo extensive and invasive evaluations to establish a definitive diagnosis. A previously healthy 4-year old girl, newly diagnosed with suprasystemic pulmonary hypertension required multiple lung biopsies. Each procedure was associated with significant bleeding. The challenging anesthetic management of lung biopsy in the presence of suprasystemic pulmonary hypertension is described.
Asunto(s)
Anestésicos/administración & dosificación , Biopsia/métodos , Hemorragia/etiología , Hipertensión Pulmonar/diagnóstico , Biopsia/efectos adversos , Preescolar , Femenino , Humanos , Enfermedades Pulmonares/diagnósticoRESUMEN
Although early treatment with intravenous immunoglobulin reduces the risk of coronary artery aneurysms, in refractory cases of Kawasaki disease, myocardial infarction can result from thrombosis of coronary artery aneurysms. Early recognition of myocardial infarction from Kawasaki disease myocarditis can reduce morbidity and mortality. This report describes successful treatment of myocardial infarction from coronary thrombosis in an infant with Kawasaki disease using intravenous tissue plasminogen activator and abciximab.
Asunto(s)
Trombosis Coronaria/complicaciones , Síndrome Mucocutáneo Linfonodular/complicaciones , Infarto del Miocardio/tratamiento farmacológico , Abciximab , Anticuerpos Monoclonales/administración & dosificación , Anticuerpos Monoclonales/uso terapéutico , Trombosis Coronaria/tratamiento farmacológico , Trombosis Coronaria/etiología , Fibrinolíticos/administración & dosificación , Fibrinolíticos/uso terapéutico , Humanos , Fragmentos Fab de Inmunoglobulinas/administración & dosificación , Fragmentos Fab de Inmunoglobulinas/uso terapéutico , Lactante , Masculino , Infarto del Miocardio/etiología , Inhibidores de Agregación Plaquetaria/administración & dosificación , Inhibidores de Agregación Plaquetaria/uso terapéutico , Activador de Tejido Plasminógeno/administración & dosificación , Activador de Tejido Plasminógeno/uso terapéutico , Resultado del TratamientoRESUMEN
Plastic bronchitis is potentially a life-threatening complication of long-standing surgically palliated single ventricle congenital heart disease. Patients can present with hypoxia requiring urgent bronchoscopy for removal of bronchial casts. Perioperative care for these patients is challenging and anesthesia is associated with significant cardiac risk. As more surgically corrected single ventricle patients survive to adulthood, these patients are expected to present more frequently. This report details the perioperative management of 2 Fontan patients with hypoxia and significant plastic bronchitis disease burden.
