Assuntos
Complicações Intraoperatórias/terapia , Guias de Prática Clínica como Assunto , Escoliose/cirurgia , Traumatismos da Medula Espinal/terapia , Fusão Vertebral/efeitos adversos , Adolescente , Adulto , Algoritmos , Criança , Terapia Combinada , Contraindicações , Drenagem , Humanos , Hipotermia Induzida , Fixadores Internos/efeitos adversos , Hipertensão Intracraniana/etiologia , Hipertensão Intracraniana/prevenção & controle , Hipertensão Intracraniana/cirurgia , Complicações Intraoperatórias/tratamento farmacológico , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/prevenção & controle , Isquemia/etiologia , Isquemia/prevenção & controle , Isquemia/terapia , Metilprednisolona/uso terapêutico , Monitorização Intraoperatória/métodos , Monitorização Intraoperatória/estatística & dados numéricos , Fármacos Neuroprotetores/uso terapêutico , Medula Espinal/irrigação sanguínea , Traumatismos da Medula Espinal/tratamento farmacológico , Traumatismos da Medula Espinal/etiologia , Traumatismos da Medula Espinal/prevenção & controleRESUMO
Improvements in myocardial protection, surgical techniques, and perioperative care have made it possible to achieve better prognosis in most congenital heart defects. This requires a coordinated, multidisciplinary approach to patient care, based on the preservation of adequate oxygen delivery to vital organs. It is important to have an understanding of normal postoperative status after cardiac surgery so that abnormal postoperative convalescence can be identified and treated.The causes of abnormal convalescence may be grouped into three categories: a) the pathophysiology of the defect before surgery and the acute changes in physiology that result from surgery; b) the effects of hypothermic cardiopulmonary bypass and deep hypothermic circulatory arrest on organ function, and c) the presence of residual anatomic defects. These conditions may result in prolonged convalescence as well as increased morbidity and mortality. Three primary hemodynamic pathophysiologic disturbances may occur during the postoperative period and lead to abnormal convalescence: left ventricular dysfunction, right ventricular dysfunction and pulmonary hypertension. Though sometimes not directly related to either the cardiac defect or surgery, specific problems involving different organs may alter the normal postoperative period. Neurologic, pneumologic, renal, gastrointestinal and infective complications are discussed separately.