Anaesthesia for neonatal cardiac surgery

Chengode, Suresh; Menon, Priya

doi:10.4103/0971-9784.37947

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…64 Chengode and Menon recommended NIRS to detect critical cerebralhypoxia in a review of neonatal cardiac surgery. 65…”

Section: Pediatric Cardiac Surgerymentioning

confidence: 99%

Cerebral oximetry using near-infrared spectroscopy (NIRS) in cardiovascular and thoracic anaesthesia: A review

Sarkar¹,

Kanchi²

2022

IJCA

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Near-infrared Spectroscopy (NIRS) has a well-established role in cardiovascular and thoracic anaesthesia, and its use is increasing in popularity. Regional cerebral oxygen saturation monitoring may be helpful for patients who are at risk for cerebral ischemia. During cardiac induction, there is a risk of developing complications like arrhythmias, hypotension, cardiac arrest, ST-segment changes, acute low cardiac output, pulmonary hypertension, diastolic dysfunction, valve dysfunction, residual shunts, or residual obstruction of ventricular outflow tracts, brain injuries, etc; where cerebral oxygen saturation is affected. These complications are multifactorial due to the use of heartlung machines as a result of the issues of aorto-pulmonary shunts, pathophysiological changes in the cardiovascular system, hypothermia, circulatory arrest (DHA), prolonged CPB time, specific surgical technique, anaesthesia, and different medications. The non-invasive, compact, continuous measurement technology known as NIRS tracks oxygenation in the brain, muscle, and other organs. In real time, it senses small changes in tissue oxygenation. We hypothesized that NIRS would be a useful technique for detecting increased susceptibility to ischemic neurologic harm. It could be a helpful technique for tracking brain oxygenation when jugular bulb oxygen saturation monitoring is not an option. NIRS is a useful tool for predicting critical events and figuring out how to handle them for a better outcome and faster discharge.

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“…64 Chengode and Menon recommended NIRS to detect critical cerebralhypoxia in a review of neonatal cardiac surgery. 65…”

Section: Pediatric Cardiac Surgerymentioning

confidence: 99%

Cerebral oximetry using near-infrared spectroscopy (NIRS) in cardiovascular and thoracic anaesthesia: A review

Sarkar¹,

Kanchi²

2022

IJCA

View full text Add to dashboard Cite

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“…Significant progress has been made in neonatal cardiac surgery in the recent two decades. 1, 2, 3, 4 The mortality and morbidity after neonatal cardiac surgery have decreased considerably in the recent past. 5, 6 Biventricular complete repair in neonates and small-weight babies can be performed with good early- and mid-term results.…”

Section: Introductionmentioning

confidence: 99%

Surgeries in Neonates and Small-Weight Babies With Congenital Heart Diseases: Challenges and Gratification

Dharmapuram

Ramakrishnan

Goutami

et al. 2020

Indian Journal of Clinical Cardiology

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Background: Complex cardiac surgery in neonates and small-weight babies is a challenge. In addition to the surgical expertise and skill required, accurate diagnosis, management of anesthesia, perfusion, and postoperative critical care are equally challenging. Methods: We have analyzed the data of 4 different examples of complex cardiac surgery in neonates and small-weight babies from February 2012 to July 2019 in our unit. The first group included 118 cases of arterial switch operations for transposition of great arteries with and without ventricular septal defect (group 1). The second group included 52 patients of aortic arch repair from midline using selective cerebral perfusion avoiding total circulatory arrest (group 2). The third group included 75 patients of repair of coarctation of aorta from thoracotomy using the modified end-to-side technique (group 3). The fourth group included 40 neonates and small-weight babies who underwent repair of total anomalous pulmonary venous connection (group 4). Results: In group 1, there was hospital mortality in 6 babies. In group 2, there was no hospital mortality. In group 3, there was 1 hospital death; in group 4, there were 5 hospital deaths. The major contributing cause of death was respiratory or blood-borne infection causing respiratory issues leading to prolonged ventilation. Left diaphragm palsy contributed to morbidity and eventual death in 2 babies. Only 2 patients required tracheostomy to wean off the ventilator. Conclusions: In the present day, it is possible to achieve satisfactory results with acceptable mortality in neonatal cardiac surgery. Morbidity associated with very early repair in neonatal age, low weight, and infection-related issues is manageable with good outcomes.

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TIVA versus Inhalational Agents for Pediatric Cardiac Intensive Care

Kashav

Kohli

Magoon

et al. 2021

Journal of Cardiac Critical Care TSS

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The field of pediatric intensive care has come a long way, especially with the recognition that adequate sedation and analgesia form an imperative cornerstone of patient management. With various drugs available for the same, the debate continues as to which is the better: total intravenous anesthesia (TIVA) or inhalational agents. While each have their own advantages and disadvantages, in the present era of balance toward the IV agents, we should not forget the edge our volatile agents (VAs) might have in special scenarios. And ultimately as anesthesiologists, let us not forget that be it knob and dial, or syringe and plunger, our aim is to put pain to sleep and awaken a new faith to breathe.

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Anaesthesia for neonatal cardiac surgery

Cited by 3 publications

References 27 publications

Cerebral oximetry using near-infrared spectroscopy (NIRS) in cardiovascular and thoracic anaesthesia: A review

Cerebral oximetry using near-infrared spectroscopy (NIRS) in cardiovascular and thoracic anaesthesia: A review

Surgeries in Neonates and Small-Weight Babies With Congenital Heart Diseases: Challenges and Gratification

TIVA versus Inhalational Agents for Pediatric Cardiac Intensive Care

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