Department of Anaesthesiology and Intensive Care Medicine, Medical University Graz, Austria
[Applied Cardiopulmony Pathophysiology: 13: 34-40, 2009]
Management of children and adolescents with congenital heart disease during cardiac catheterization is a challenge for the attending anaesthetist. According to other diagnostic procedures such as CT-scan and MRT, it is not always necessary to perform general anaesthesia with intubation. The aim of the anaesthesiologic management is to facilitate cardiac catheterization under physiological conditions in a spontaneously breathing, deeply sleeping patient, who is free of pain. In general, these goals are met by procedural sedation. In contrast, positive pressure ventilation with PEEP causes changes of the intrapulmonary pressure influencing intracardiac pressure and shunt volumes. Indications and contraindications for procedural sedation have to be kept in mind and profound knowledge of the individual heart disease is necessary. It has to be decided whether the individual patient is a candidate for procedural sedation or whether in rare cases general anaesthesia has to be performed.
Keywords: procedural sedation, children, congenital heart disease, cardiac catheterization
Address for corresponding: Maria Vittinghoff, M.D., Universitätsklinik für Anästhesiologie und Intensivmedizin, Medizinische Universität Graz, Auenbruggerplatz 29, A-8036 Graz, Austria, firstname.lastname@example.org