Mechanical Ventilation Following Cardiac Surgery in Children

Alexandre      Tellechea Rotta; Werther      Brunow de Carvalho

Abstract

The application of positive pressure mechanical ventilation can result in complex changes in pulmonary and cardiovascular physiology. These cardiopulmonary interactions are particularly important in pediatric patients undergoing surgery for repair or palliation of congenital cardiac defects. In this article, we review the various effects of mechanical ventilation on right and left ventricular preload, afterload and contractility. We also address specific clinical scenarios, such as mechanical ventilation of the uncomplicated patient following cardiac surgery, ventilation of patients with delayed sternal closure, the Norwood procedure, bidirectional and total cavopulmonary anastomoses and patients with right ventricular diastolic dysfunction.

Keywords: Heart-lung interactions, cardiorespiratory interactions, cardiocirculatory function, systemic hemodynamics, cardiovascular monitory, mechanical ventilation, cardiac surgery, cardiopulmonary interactions, congenital cardiac defects