Perioperative management of Fontan operation for the child with panhypopituitarism: a case report
| Autor: | Tatsuya Nagano, Yoji Otsuka, Masaaki Kawada, Hidetaka Iwai, Mamoru Takeuchi, Naoyuki Taga, Kohei Sunoki |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Heart Defects
Congenital Male congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Heart disease Heart Ventricles Pulmonary Artery Fontan Procedure Hypopituitarism 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Anesthesiology Ascites medicine Humans Child Pediatric intensive care unit business.industry 030208 emergency & critical care medicine medicine.disease Craniopharyngioma Anesthesiology and Pain Medicine Child Preschool Anesthesia Diabetes insipidus medicine.symptom business Pulmonary atresia Shunt (electrical) |
| Zdroj: | Journal of Anesthesia. 35:303-306 |
| ISSN: | 1438-8359 0913-8668 |
| Popis: | With the surgical improvement of congenital heart disease, Fontan operation has been applied to many complicated patients in recent years. This is the first report of a child with panhypopituitarism who underwent Fontan operation. A 5-year-old boy was scheduled for Fontan operation. He previously underwent Blalock-Taussig shunt and bidirectional Glenn operations for univentricular heart with double-outlet right ventricle and pulmonary atresia. He was receiving hydrocortisone and 1-desamino-8-D-arginine vasopressin (DDAVP) for panhypopituitarism secondary to removal of craniopharyngioma performed at the age of three years. Although urine output and serum sodium concentration were adequately controlled by adjustment of vasopressin infusion rate during surgery, massive pleural effusions and ascites developed postoperatively, which required several days for control by adjusting the dose of oral DDAVP and normalize the serum sodium level. Intraoperative management of Fontan operation for a patient with panhypopituitarism was controllable by appropriate hormone replacement. However, postoperative fluid management was complicated by the clinical features of panhypopituitarism and Fontan physiology. |
| Databáze: | OpenAIRE |
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