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Management of the Critically Ill Adult With Congenital Heart Disease

Wolf B Kratzert1, Eva K Boyd1, Johanna C Schwarzenberger1

  • 1Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, Los Angeles, CA.

Journal of Cardiothoracic and Vascular Anesthesia
|March 4, 2018
PubMed

Insights

Adults with congenital heart disease (CHD) are increasingly admitted to intensive care units (ICUs) due to long-term complications. Critical care requires understanding complex anatomy and comorbidities for optimal outcomes.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Adult Congenital Heart Disease

Background:

  • Survival rates for adults with congenital heart disease (CHD) have significantly improved.
  • This has led to a rise in hospital and intensive care unit (ICU) admissions for this population.
  • Medical emergencies from long-term sequelae of CHD treatment are now more common than perioperative issues.

Purpose of the Study:

  • To review the management of critically ill adults with congenital heart disease.
  • To discuss the complex anatomy, pathophysiology, and comorbidities associated with CHD.
  • To explore adjustments in ICU management and pharmacology for this unique patient group.

Main Methods:

  • Review of current literature on adult congenital heart disease critical care.
  • Discussion of common CHD lesions and surgical approaches.
  • Analysis of long-term sequelae and comorbidities affecting organ systems.

Main Results:

  • Adults with CHD present complex anatomical and pathophysiological challenges in the ICU.
  • Comorbidities across multiple organ systems (cognitive, pulmonary, cardiovascular, hepatic, renal) are prevalent.
  • Contemporary adult ICU care concepts need adaptation for CHD patients.

Conclusions:

  • Critical care for adults with CHD demands specialized knowledge of their unique physiology.
  • Understanding the interplay of CHD, aging, and comorbidities is crucial for effective management.
  • Optimizing ICU care involves tailored management strategies and pharmacology to improve patient outcomes.

Keywords:
adult congenital heart diseasecongenital heart diseasecritical carecritically illintensive care unit

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