%0 Journal Article
%T Anesthesia of a child with open Botalli¡¯s duct ¨C a case report
%A Curi£¿ Radivojevi£¿
%A Renata
%A Karmeli£¿
%A Dora
%A Maji£¿
%A Matija
%A Mandi£¿
%A Marin
%J -
%D 2020
%R 10.26800/LV-142-1-2-6
%X Sa£¿etak The 8-year-old boy was scheduled for an elective tonsillectomy because of a recurring middle ear infection, caused by adenoid hypertrophy. The patient had a patent ductus arteriosus (PDA), a common congenital heart defect with a persistent communication between the aorta and the pulmonary artery. In this patient, there was only a haemodynamically insignificant left-to-right shunt. Current guidelines for anaesthetic management of patients with left-to-right shunt include: 1. Maintenance or decrease of systemic vascular resistance (SVR) as a haemodynamic goal; 2. Avoiding decreases in pulmonary vascular resistance (PVR); 3. Avoiding hyperoxia and hypocarbia. The preoperative assessment included collaboration with paediatric cardiologist who reevaluated the patient¡¯s cardiac status, including a heart ultrasound and an ECG cardiography. The course of anaesthesia was uneventful. After neuromuscular blockade reversion and extubation, the patient was transferred to the post-anesthesia care unit (PACU) awake, haemodynamically stable and with satisfactory respiratory status. The preoxygenation with 100% oxygen is a source of controversy. In a patient with PDA, a thorough preoperative evaluation of cardiac status and avoidance of worsening left-to-right shunt are essential for good outcome
%K DUCTUS ARTERIOSUS
%K PATENT ¨C physiopathology
%K ANESTHESIA
%K GENERAL ¨C methods
%K PULMONARY ARTERY ¨C physiopathology
%K VASCULAR RESISTANCE
%K HEMODYNAMICS
%K OXYGEN
%K PERIOPERATIVE CARE
%K TONSILLECTOMY
%U https://hrcak.srce.hr/index.php?show=clanak&id_clanak_jezik=343683