Pediatric anesthesia & critical care
Anesthetic management of children with medically refractory pulmonary hypertension undergoing surgical Potts shunt
Authors' conclusion
Our single center expereince shows that the Potts shunt surgery, despite high short-term mortaility, may offer another option for palliation in children with medically refractory pulmonary hypertension.
Study context
- Population
- Children <18 years with medically refractory pulmonary hypertension undergoing surgical Potts shunt, April 2013–June 2022
- Participants
- 29 children
- Outcome
- Intraoperative management
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Median age, years (range 4 months to 17.4 years)
- 12
- Placed via thoracotomy
- 19 (65%)
- Placed via median sternotomy with CPB
- 10 (35%)
- Ketamine as induction agent
- 17 out of 29, 59%
- Vasopressin started before intubation
- 20 out of 29, 69%
- Inotropic support before shunt placement: epinephrine
- 45%
- Inotropic support before shunt placement: milrinone
- 28%
- Inotropic support before shunt placement: norepinephrine
- 17%
- Inotropic support before shunt placement: dobutamine
- 14%
- Support after shunt opening: vasopressin
- 66%
- Support after shunt opening: epinephrine
- 62%
- Support after shunt opening: milrinone
- 59%
- Support after shunt opening: dobutamine
- 14%
- Support after shunt opening: norepinephrine
- 10%
Observational data: associations, not effects.
Safety
Major intraoperative complications and in-hospital mortality
- Severe hypoxemia
- 21 out of 29, 72%
- Hypotension requiring epinephrine boluses
- 10 out of 29, 34.5%
- Intraoperative cardiac arrest
- 0
- In-hospital mortalities
- 4
Original publication
Anesthetic management of children with medically refractory pulmonary hypertension undergoing surgical Potts shunt. Paediatr Anaesth. Published 6 October 2023. doi:10.
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