Pediatric Renal Transplant With Dilated Cardiomyopathy: A Stepwise Hemodynamic Management-A Case Report.

IF 0.5 A&A Practice Pub Date : 2023-09-01 DOI:10.1213/XAA.0000000000001709

Kashish Garg, Choro Athiphro Kayina, Kamal Kajal, Krishna Prasad Gourav, Ashish Aditya, Sameer Sethi, Deepesh B Kenwar

引用次数: 0

Abstract

Here we have described the anesthetic management of a 10-year-old patient having uremia-induced dilated cardiomyopathy for a living-related adult to pediatric renal transplant. Maintaining optimal hemodynamics, especially during the reperfusion phase, is crucial for maintaining graft perfusion. However, dilated cardiomyopathy limits indiscriminate fluid administration as it may cause congestive heart failure and pulmonary edema. We have described the fluid therapy algorithm based on the plethysmography variability index and velocity time integral at the left ventricular outflow tract, which was able to limit excessive fluid administration and maintain adequate perfusion pressures.

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儿童肾移植合并扩张型心肌病:分步血流动力学处理一例报告。

在这里，我们描述了一名10岁的尿毒症引起的扩张型心肌病患者的麻醉管理，这是一名与生活相关的成人到儿科肾移植。维持最佳的血流动力学，特别是在再灌注阶段，对于维持移植物灌注至关重要。然而，扩张型心肌病限制任意输液，因为它可能导致充血性心力衰竭和肺水肿。我们描述了基于容积描记变异性指数和左心室流出道流速时间积分的液体治疗算法，该算法能够限制过量的液体给药并保持足够的灌注压力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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A&A Practice ANESTHESIOLOGY-

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期刊介绍： A & A Case Reports, our new online journal publishing Case Reports, related Editorial Commentary, and Correspondence. Anesthesia & Analgesia 1 and Anesthesiology 2 recently announced that they were suspending publication of Case Reports. One reason is that Case Reports typically reduce the Impact Factor of a journal because they are rarely cited. Regardless of the merits of Impact Factor as a metric of journal worth, journals and their editors necessarily consider Impact Factor in strategic planning. At the same time, Case Reports are appreciated by readers for describing “real life” management of difficult or unusual cases not often encountered by practitioners. In a recent issue of Anesthesia & Analgesia, Steven Shafer1 identified many Case Reports whose publication launched productive careers dedicated to solving the puzzle posed by an unusual observation in a single patient.