Perioperative management of Fontan operation for the child with panhypopituitarism: a case report.
J Anesth
; 35(2): 303-306, 2021 04.
Article
em En
| MEDLINE
| ID: mdl-33449198
ABSTRACT
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.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Técnica de Fontan
/
Cardiopatias Congênitas
/
Hipopituitarismo
Tipo de estudo:
Etiology_studies
Limite:
Child
/
Child, preschool
/
Humans
/
Male
Idioma:
En
Revista:
J Anesth
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Japão