Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
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Case Report

Volume 9, Number 1, February 2018, pages 53-58


Successful Surgical Repair and Perioperative Management of 6-Month-Old With Total Anomalous Pulmonary Venous Return in a Developing Country: Considerations for the Treatment of Pulmonary Hypertension

Table

Table 1. Management of Perioperative Pulmonary Hypertensive Crisis
 
1. Correct hypoxemia and hypercarbia
2. Administer 100% oxygen
3. Hyperventilation
4. Maintain normothermia
5. Alkalization with the administration of sodium bicarbonate
6. Treat noxious stimuli by deepening the level of anesthesia or administering opioids such as fentanyl
7. After sedation and analgesia, provide neuromuscular blockade
8. Support cardiac output by administering fluid or inotropic agents
  Vasopressin is preferable to adrenergic agents to increase mean arterial pressure without raising pulmonary artery pressure
9. Pharmacologic therapies
  Nitric oxide
  Increase intracellular cyclic GMP by inhibiting phosphodiesterase 5
    Milrinone
    Sildenafil (PR or NG)
  Augment prostaglandin G2 (prostacyclin) system (systemic or inhaled)
    Epoprostenol (Flolan®)
    Treprostinil (Remodulin®)
  Inhibit endothelin system
    Bosentan
  Miscellaneous agents
    Nesiritide
    levosimendan