Paediatric anaesthesia
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Paediatric anaesthesia · May 2011
ReviewApproach to managing children with heart disease for noncardiac surgery.
Congenital heart disease is the commonest birth defect, and advances in modern medicine mean 90% of these children now survive to adulthood. Therefore, many children present to their local hospital requiring general anesthesia for common childhood conditions. They pose a challenge for anesthesia because perioperative morbidity and mortality is greater compared with other children. ⋯ In a rapidly advancing field such as cardiac surgery, studies of long-term complications may be out of date by the time they are published, limiting applicability of the results. Because of these factors, claims of efficacy and safety of various approaches to managing children with heart disease for noncardiac surgery must be interpreted cautiously. This narrative review aims to present the evidence concerning a range of anesthetic techniques, the long-term complications of congenital heart disease and suggest a physiological and evidence-based approach to managing these children.
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Paediatric anaesthesia · May 2011
Mortality as an outcome measure following cardiac surgery for congenital heart disease in the current era.
Mortality following cardiac surgery for congenital heart disease is rare in the current times. In this review article, we explore current mortality rates, factors associated with mortality, and pitfalls in the use of mortality as a measure for assessing outcomes following congenital heart surgery.