Kaoru Tsuboi, Misuzu Asai, Toshiki Nakamura, Jun Ninagawa, Hiroshi Ono, Shugo Kasuya
National Center for Child Health and Development. Yokohama City University Hospital.
Japan
Journal of Anesthesia Clinical Reports
JA Clin Rep 2024; 10:
DOI: 10.1186/s40981-024-00699-z
Abstract
Pulmonary hypertension is associated with significant risk of perioperative life-threatening events. We present a case of a 12-year-old child with severe pulmonary arterial hypertension who successfully underwent diagnostic cardiac catheterization under ketamine and dexmedetomidine sedation with the support of high-flow nasal oxygen. Ketamine and dexmedetomidine are reported to have minimal effect on pulmonary vasculature in children with pulmonary hypertension and can be safely used in this population along with its lack of respiratory depression. Positive pressure generated by high-flow nasal oxygen improves upper airway patency, prevents micro-atelectasis, and is shown to improve the effectiveness of ventilation and oxygenation in patients under sedation breathing spontaneously. The presented strategy may contribute to enhancing the safety and effectiveness of procedural sedation for children with life-threatening pulmonary hypertension.
Category
Class I. Idiopathic Pulmonary Hypertension
Procedural Risk and Care for Individuals with Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes