Implicaciones anestésicas del Síndrome de cimitarra para cirugía no cardiaca

Ana Maria Luna-Durán, Gina González-Serrano, Piedad Echeverry
2015 Colombian Journal of Anesthesiology  
Intubation Child Anesthesia a b s t r a c t We present a clinical case report of a child with scimitar syndrome and a review of the literature in order to describe the main surgical and anesthetic implications of these patients. Child, 4 months old, weight 4700 g, diagnosed with pneumonia and left lobar emphysema requires mechanical intubation and ICU care. The associated diagnoses are failed extubation, severe pulmonary hypertension and scimitar syndrome confirmed with echocardiography. He was
more » ... scheduled for pulmonary lobectomy. His mother signed an informed consent authorization for anesthesia and surgery. The child entered surgery, intravenous anesthetic induction was performed and a central venous catheter, an arterial line, urinary catheter and pre-and post-ductal pulse oximeters were inserted. He required vasopressor support with dopamine and transfusion of red blood cells. No adverse events during surgery. At the end of the surgery he was carried back to pediatric ICU and intubated with a chest tube. Extubation was successfully performed 2 days later with favorable progress. Scimitar syndrome is characterized by an anomalous right pulmonary venous return associated with congenital heart disease and pulmonary malformations. It has a low prevalence in the population but a very high perioperative morbidity and mortality, especially in children. With this report we present the main standards and practices for anesthetic management, monitoring and hemodynamic goals with these patients. w w w. r e v c o l a n e s t . c o m . c o Cimitarra se caracteriza por un drenaje venoso pulmonar anómalo derecho asociado a cardiopatías congénitas y malformaciones pulmonares. Tiene una prevalencia baja dentro de la población pero una morbimortalidad perioperatoria muy alta sobretodo en niños. Con este reporte se presentan unas pautas concretas y prácticas para el manejo anestésico, la monitorización y las metas hemodinámicas de estos pacientes.
doi:10.1016/j.rca.2015.03.006 fatcat:axiwn4jsingdfkyp5lwzvzijcm