Abstract
Pulmonary complications are the most common causes of morbidity and mortality in the postoperative period after congenital heart surgery. In this review we discuss the diverse pathological mechanisms that contribute to these pulmonary complications. Both mechanical and gas exchange abnormalities result in increased ventilatory requirements, ICU stay and mortality. Parenchymal lung disease can be caused by a variety of conditions including nosocomial pneumonia, atelectasis and use of cardiopulmonary bypass. Direct surgical trauma to the respiratory system can result in diaphragmatic paralysis, chylothorax, subglottic stenosis or vocal cord paralysis. Disturbances in the pulmonary vasculature can also trigger complications including pulmonary embolism, plastic bronchitis and even pulmonary hypertensive crises in certain at risk populations. Close monitoring with early detection and treatment of complications often prevents prolonged ventilation and hospitalization, e.g., cases of chylothorax where early intervention is beneficial. However, the therapies used to manage some of these complications in the pediatric population are nonspecific and varied e.g., therapies for postoperative atelectasis or treatment of plastic bronchitis. There is a paucity of studies that directly address therapy for many of these complications and more randomized controlled trials in the pediatric population are needed.
Keywords: Congenital heart surgery, atelectasis, nosocomial pneumonia, cardiopulmonary bypass, diaphragmatic paralysis, chylothorax, pulmonary embolism, plastic bronchitis, Pulmonary complications, heart surgery, gas exchange, Parenchymal lung disease, pneumonia, Parenchymal Disease
Current Respiratory Medicine Reviews
Title: Pulmonary Complications After Congenital Heart Surgery
Volume: 7 Issue: 2
Author(s): Fiona Healy, Brian D. Hanna and Raezelle Zinman
Affiliation:
Keywords: Congenital heart surgery, atelectasis, nosocomial pneumonia, cardiopulmonary bypass, diaphragmatic paralysis, chylothorax, pulmonary embolism, plastic bronchitis, Pulmonary complications, heart surgery, gas exchange, Parenchymal lung disease, pneumonia, Parenchymal Disease
Abstract: Pulmonary complications are the most common causes of morbidity and mortality in the postoperative period after congenital heart surgery. In this review we discuss the diverse pathological mechanisms that contribute to these pulmonary complications. Both mechanical and gas exchange abnormalities result in increased ventilatory requirements, ICU stay and mortality. Parenchymal lung disease can be caused by a variety of conditions including nosocomial pneumonia, atelectasis and use of cardiopulmonary bypass. Direct surgical trauma to the respiratory system can result in diaphragmatic paralysis, chylothorax, subglottic stenosis or vocal cord paralysis. Disturbances in the pulmonary vasculature can also trigger complications including pulmonary embolism, plastic bronchitis and even pulmonary hypertensive crises in certain at risk populations. Close monitoring with early detection and treatment of complications often prevents prolonged ventilation and hospitalization, e.g., cases of chylothorax where early intervention is beneficial. However, the therapies used to manage some of these complications in the pediatric population are nonspecific and varied e.g., therapies for postoperative atelectasis or treatment of plastic bronchitis. There is a paucity of studies that directly address therapy for many of these complications and more randomized controlled trials in the pediatric population are needed.
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Cite this article as:
Healy Fiona, D. Hanna Brian and Zinman Raezelle, Pulmonary Complications After Congenital Heart Surgery, Current Respiratory Medicine Reviews 2011; 7 (2) . https://dx.doi.org/10.2174/157339811794927879
DOI https://dx.doi.org/10.2174/157339811794927879 |
Print ISSN 1573-398X |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6387 |
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Chronic obstructive pulmonary disease (COPD) is one of the three leading causes of death worldwide, with a major prevalence in low- and middle-income countries, resulting in a high social and economic cost. It is a heterogeneous respiratory disease, treatable and preventable, that causes persistent and often progressive airway obstruction in ...read more
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