Perioperative management of Fontan operation for the child with panhypopituitarism: a case report.
Brain tumor
Congenital heart disease
Diabetes insipidus
Pediatric intensive care unit
Total cavopulmonary connection
Journal
Journal of anesthesia
ISSN: 1438-8359
Titre abrégé: J Anesth
Pays: Japan
ID NLM: 8905667
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
05
09
2020
accepted:
27
12
2020
pubmed:
16
1
2021
medline:
24
4
2021
entrez:
15
1
2021
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 33449198
doi: 10.1007/s00540-020-02894-5
pii: 10.1007/s00540-020-02894-5
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
303-306Références
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