Anesthetic Management for Pediatric Emergency Cardiac Surgery

One hundred and eight cardiac emergency operations were performed on 95 pediatric patients from July, 1981 to June, 1985 in National Cardiovascular Center. About 92% of these patients were less than 12 months old and about 42% were less than 4 weeks old. Operations were performed in 100 cases because of either congestive heart failure, hypoxia or both which could not be controlled medically. Other reasons for surgeries were arrhythmia for 6 patients, respiratory problem for 1 and closure of the sternum for 1. On the basis of pathophysiology of the disease, these cases were classified into 6 groups; 1)low pulmonary flow group (27 patients), 2)high pulmonary flow group (32 patients), 3)pulmonary venous congestion or outlet disturbance of the heart (25 patients), 4)group with anomalies of the aortic arch (16 patients), 5)arrhythmia group (6 patients), and 6)other group (2 patients). As these cases have many high risk factors such as pediatric, cardiac and emergency, anesthesiologists should fully understand the anatomic and hemodynamic characteristics of the disease, as well as the effects of drugs and anes thetic management on the hemodynamics.