Pediatric anesthesia & critical care
Anesthetic Management for Aspiration Thrombectomy Using the Penumbra Indigo System in Pediatric Patients with Congenital Heart Disease
Authors' conclusion
Mechanical aspiration thrombectomy is being increasingly used to treat critically ill pediatric patients and presents unique anesthetic considerations, particularly related to the need for volume and blood product resuscitation.
Study context
- Population
- Patients aged <18 years with congenital heart disease undergoing aspiration thrombectomy, quaternary academic children's hospital, November 2017 to February 2022
- Participants
- 13 patients
- Outcome
- Clinical characteristics and outcomes, including transfusion requirements
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Median age (years)
- 3.8
- Median weight (kg)
- 15.2
- Palliated single ventricle circulation
- 7
- Biventricular circulation
- 6
- Intensive care unit (ICU) admission before procedure
- 9
- ICU admission after procedure
- 12
- Indication: systemic venous thrombus
- 7
- Indication: pulmonary arterial thrombus
- 3
- Indication: systemic arterial thrombus
- 2
- Indication: systemic-to-pulmonary shunt occlusion
- 1
- Median estimated blood loss, mL/kg (IQR 1.4-15.8; range 0.5-51.5)
- 7.7
- Intraoperative transfusion required (RBC n = 4, FFP n = 2, platelets n = 3, cryoprecipitate n = 1)
- 7
- Median transfusion volume in transfused patients, mL/kg (IQR 14.1-59.7; 9.3-132.8)
- 22
- Successful thrombectomy
- 8 of 13
- Recurrent thrombosis among successful
- 3 of these 8
Observational data: associations, not effects.
Original publication
Anesthetic Management for Aspiration Thrombectomy Using the Penumbra Indigo System in Pediatric Patients with Congenital Heart Disease. J Cardiothorac Vasc Anesth. Published 10 August 2024. doi:10.
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