Effective Postoperative Use of Dexmedetomidine in a Child with Severe Pulmonary Arterial Hypertension Secondary to Congenital Ventricular Septal Defect.
10.4266/kjccm.2015.30.1.34
- Author:
Yong In KIM
- Publication Type:Case Report
- Keywords:
congenital heart disease;
dexmedetomidine;
pulmonary arterial hypertension
- MeSH:
Administration, Intravenous;
Adult;
Cardiopulmonary Bypass;
Child*;
Child, Preschool;
Dexmedetomidine*;
Heart Defects, Congenital;
Heart Septal Defects, Ventricular*;
Hemodynamics;
Humans;
Hypertension*;
Hypnotics and Sedatives;
Intensive Care Units;
Nitroglycerin;
Oxygen;
Tricuspid Valve Insufficiency;
Ventilator Weaning;
Ventilators, Mechanical;
Weaning
- From:Korean Journal of Critical Care Medicine
2015;30(1):34-37
- CountryRepublic of Korea
- Language:English
-
Abstract:
Although alpha2-adrenoceptor agonists are widely used as postoperative sedatives in adults, the postoperative effects in pediatric patients with secondary pulmonary arterial hypertension (PAH) due to congenital heart disease are not well known. We experienced a case of successful ventilator weaning with continuous intravenous administration of dexmedetomidine (DEX) after surgical correction in a 46-month-old child with congenital ventricular septal defect (VSD) with severe PAH. She underwent VSD closure on cardiopulmonary bypass (CPB). After successful weaning from the CPB, hemodynamics and oxygenation were stabilized on DEX and nitroglycerin in the intensive care unit. The patient was successfully weaned from the ventilator 46 hours after surgery. The transthoracic echocardiogram two weeks after surgery showed a closed VSD with no residual shunt and trivial tricuspid regurgitation (Vmax = 2.5 m/sec) without PAH.
