Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access |
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Case Report
Volume 9, Number 1, February 2018, pages 53-58
Successful Surgical Repair and Perioperative Management of 6-Month-Old With Total Anomalous Pulmonary Venous Return in a Developing Country: Considerations for the Treatment of Pulmonary Hypertension
Table
1. Correct hypoxemia and hypercarbia |
2. Administer 100% oxygen |
3. Hyperventilation |
4. Maintain normothermia |
5. Alkalization with the administration of sodium bicarbonate |
6. Treat noxious stimuli by deepening the level of anesthesia or administering opioids such as fentanyl |
7. After sedation and analgesia, provide neuromuscular blockade |
8. Support cardiac output by administering fluid or inotropic agents |
Vasopressin is preferable to adrenergic agents to increase mean arterial pressure without raising pulmonary artery pressure |
9. Pharmacologic therapies |
Nitric oxide |
Increase intracellular cyclic GMP by inhibiting phosphodiesterase 5 |
Milrinone |
Sildenafil (PR or NG) |
Augment prostaglandin G2 (prostacyclin) system (systemic or inhaled) |
Epoprostenol (Flolan®) |
Treprostinil (Remodulin®) |
Inhibit endothelin system |
Bosentan |
Miscellaneous agents |
Nesiritide |
levosimendan |