Intensive Care and Perioperative Management of Neonates With Functionally Univentricular Hearts.
ABSTRACT Although mortality rates for patients with univentricular hearts continue to fall, the course in the intensive care unit is remarkable for significant morbidity and utilization of significant resources. Preoperative patient management focuses on balancing competing circulations, pulmonary and systemic, which exist in parallel rather than in series, as in the normal circulation. Postoperative patient management focuses on optimizing systemic output, respiratory status, and mitigating the effects of cardiopulmonary bypass. In this article, we review pre- and postoperative intensive care management in neonates with a univentricular heart.
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ABSTRACT: Every year in the United States approximately 40,000 infants are born with congenital heart disease. Several of these infants require corrective or palliative surgery in the neonatal period. Mortality rates after cardiac surgery are highest amongst neonates, particularly those born prematurely. There are several reasons for the increased surgical mortality risk in neonates. This review outlines these risks, with particular emphasis on the relative immaturity of the organ systems in the term and preterm neonate.Pediatric Cardiac Surgery Annual of the Seminars in Thoracic and Cardiovascular Surgery 01/2013; 16(1):21-31. DOI:10.1053/j.pcsu.2013.01.007