Desaturation in an infant with univentricular circulation during gastroscopic intervention - a brief disconnection of the tube may be helpful

作者：Kaufmann J^*; Bangen U; Kindernnann P; Laschat M; Wappler F

来源：Anasthesiologie & Intensivmedizin, 2014, 55: 614-619.

• Fontan Circulation
• Laparoscopy
• Narcosis
• Infant
• Ventilation

We report of an almost three-year-old boy with congenital heart defect (double inlet left ventricle - DILV) with completed Fontan circulation, who was admitted for a gastroscopic intervention. Due to a bronchomalacia and the needed insufflation of the stomach, high ventilation pressures became necessary and caused a significant decrease of the pulmonary perfusion. Apart from other measures, the situation was stabilized by intermittent, short-term discontinuation of the ventilation. This case report describes the particular cardiopulmonary physiology in Fontan circulations and their significance for the anaesthesiological care in general and for situations with increased intra-abdominal pressure. Knowledge of this particular circulation physiology may be required for every anaesthesiologist or emergency physician on account of the increasing likelihood of becoming responsible for such patients at the operating theatre or within emergency care structures.

• 出版日期2014-11