Management of Elevated ICP After Bidirectional Glenn

MedEdPORTAL

Srijaya Reddy¹  Andrew Matisoff² 

[1] 1 Children's National Medical Center;2 Children's National Medical Center;

关键词: Neurophysiology;    ICP;    Congential Cardiac;    Bidirectional Glenn Shunt;    Single Ventricle;    HLHS;   

DOI  :  10.15766/mep_2374-8265.9998

来源: DOAJ

【 摘 要 】

Abstract Introduction This problem-based learning discussion (PBLD) resource addresses the challenges of managing elevated intracranial pressure (ICP) in an infant with bidirectional Glenn (BDG) physiology. It is primarily aimed at pediatric cardiac anesthesiologists but is also applicable to anyone who takes care of patients with complex congenital cardiac disease. Methods The clinical scenario involves a pediatric patient with CHARGE syndrome and hypoplastic left heart syndrome (HLHS) status following a BDG procedure, requiring an emergent evacuation of a large subdural hematoma. This case highlights the cardiovascular physiology of patients after a BDG procedure and the unique relationship between cerebral and pulmonary circulation in these patients. After presentation of the case stem, the instructor moderates a student-focused group discussion using a series of questions that build upon the case and a review of the current literature. Results This PBLD was presented at the Society for Pediatric Anesthesia/American Academy of Pediatrics Pediatric Anesthesiology Annual Meeting in Ft. Lauderdale, FL in March 2014. Evaluations of this PBLD were uniformly positive. In addition, this PBLD was presented as an educational tool for the pediatric anesthesiology fellows at the authors' institution. Evaluations of this activity by the fellows were also uniformly positive. This activity has helped our fellows master the concepts of HLHS and BDG physiology. Discussion This type of procedure is most likely to be performed at an institution with multidisciplinary services that routinely care for infants and children with congenital heart disease, which may limit its generalizability.

【 授权许可】

Unknown