Procedural Sedation in Congenital Heart Disease

Saadeh Al-Jureidini; Shadi Al-Jureidini; Reema Patel; Renuka Peterson; Michael Czajka; Andrew Fiore

doi:10.1055/s-0043-1762909

Journal of Pediatric Intensive Care, Table of Contents

J Pediatr Intensive Care
DOI: 10.1055/s-0043-1762909

Review Article

Procedural Sedation in Congenital Heart Disease

Saadeh Al-Jureidini

¹Division of Cardiology, Department of Pediatrics, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, Missouri, United States

,

Shadi Al-Jureidini

²Department of Pharmacy, SSM Health Cardinal Glennon Children's Hospital, St. Louis, Missouri, United States

,

Reema Patel

³American Board of Pediatrics and Subboard of Pediatric Cardiology, John Hopkins All Children's Hospital, St. Petersburg, Florida, United States

,

Renuka Peterson

¹Division of Cardiology, Department of Pediatrics, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, Missouri, United States

,

Michael Czajka

⁴Division of Cardiology, Department of Pediatrics, SSM Health Cardinal Glennon Children's Hospital, St. Louis, Missouri, United States

,

Andrew Fiore

⁵Division of Cardiothoracic Surgery, Department of Surgery, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, Missouri, United States

› Author Affiliations

Abstract

Procedural sedation in patients with congenital heart disease (CHD) is associated with significant morbidity and mortality. It is vital for the practitioner to fully understand the complexity of lesions, their hemodynamics, and the impact of medications commonly used for procedural sedation on the stability of systemic vascular resistance and pulmonary flow. According to the literature, we explain the interaction of the systemic vascular resistance and pulmonary flow in such lesions and divide them into five categories outlined in this article: (1) CHDs with left-to-right shunt with normal pulmonary arterial pressure and resistance, (2) CHD with left-to-right shunt and moderate to severe elevation of pulmonary arterial pressure with near-normal pulmonary vascular resistance, (3) CHD with pulmonary flow dependent on systemic vascular resistance, (4) patients with congenital coronary stenosis and coronary anomalies, and 5) aortic obstructive lesions.

Keywords

procedural sedation - congenital heart disease - systemic vascular resistance - pulmonary vascular resistance - surgical shunts

Full Text

References

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