Anesthetic Agents and Their Cardiovascular Effects

Andropoulos, Dean B.

doi:10.1002/9780470754986.ch4

Cited by 3 publications

(3 citation statements)

References 111 publications

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“…Ketamine is commonly used in the management of the unstable patient, as it tends to increase cardiac output via central and peripheral sympathomimetic effects. Favorable hemodynamic responses have been reported in the setting of noncardiac surgery for children with severe heart failure (22) and prior to heart transplantation in adults (23). However, a direct myocardial depressant effect may be revealed when ketamine is administered to patients whose sympathomimetic responses are already maximally stimulated (24).…”

Section: Discussionmentioning

confidence: 99%

Anesthesia for children with pericardial effusion: a case series

Rawlinson

Bagshaw

2012

Pediatric Anesthesia

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Anesthesia for pericardial effusion in children was associated with an adverse physiological event in one-third of children. Major complications may be predicted by preoperative tachypnoea and cardiac tamponade on preoperative ECHO, and all complications may be predicted by preoperative hypoxia. The anesthetic technique included a variety of induction agents, and we cannot recommend a particular approach.

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Section: Discussionmentioning

confidence: 99%

Anesthesia for children with pericardial effusion: a case series

Rawlinson

Bagshaw

2012

Pediatric Anesthesia

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“…The management of cardiac tamponade is based on supporting right ventricular preload, heart rate, and contractility (54,55). To achieve these goals, we first administered a preinduction fluid bolus as the patient had been nil per os for some time and was also thought to have had pulmonary bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, we used ketamine for sedation during intravenous access. Although ketamine has desirable indirect sympathomimetic properties (56), this drug is not always appropriate for tamponade because it also possesses direct myocardial depressant activity. In the acute trauma setting this latter effect is rarely a problem, but when cardiac reserve is low and endogenous catecholamines are depleted (e.g., pericardial effusion associated with long‐term illness), ketamine’s negative inotropism may be unmasked resulting in hemodynamic instability (54).…”

Section: Discussionmentioning

confidence: 99%

Anesthesia for a thoracic BB gun injury

Misseldine

August

2010

Pediatric Anesthesia

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Pediatric anesthesiologists care for children with penetrating trauma from nonpowder (BB and pellet) guns. We present the case of a 9-year-old boy who required urgent median sternotomy for cardiac tamponade after sustaining a close-range BB gun injury to the chest. After summarizing the epidemiology of nonpowder gun injuries in children, we clarify the nomenclature, ballistics, and mechanisms of these guns, discuss the tendency to minimize these kinds of injuries, explain bullet embolization, and review (by body area) current clinical management issues.

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General Anesthesia for Children With Severe Heart Failure

et al. 2010

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Severe heart failure in children is uncommon. The anesthetic management of children with this condition is challenging. The authors aimed to identify the frequency with which anesthesia for short noncardiac surgical procedures or investigations was complicated by life-threatening hemodynamic instability and to describe the anesthetic techniques used. This study retrospectively reviewed the anesthetic charts and notes of children admitted acutely with a diagnosis of severe heart failure (fractional shortening of 15% or less) who received general anesthesia for noncardiac surgical or diagnostic interventions during the 3-year period from September 2005 to September 2008. In this study, 21 children received a total of 28 general anesthetics. Two patients (10%) experienced a cardiac arrest, and both required unplanned admission to the authors' pediatric intensive care unit (PICU) postoperatively. A variety of anesthetic techniques was used. In 27 (96%) of the 28 cases, perioperative inotropic support was required. General anesthesia for children with severe heart failure is associated with a significant complication rate and should be administered by anesthetists familiar with managing all aspects of circulatory support for children in an appropriate setting.

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Anesthetic Agents and Their Cardiovascular Effects

Cited by 3 publications

References 111 publications

Anesthesia for children with pericardial effusion: a case series

Anesthesia for children with pericardial effusion: a case series

Anesthesia for a thoracic BB gun injury

General Anesthesia for Children With Severe Heart Failure

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