Skip to main content
SpringerLink
Log in

General Intensive Care Monitoring and Management

  • Chapter
  • First Online:
Intensive Care of the Adult with Congenital Heart Disease

Part of the book series: Congenital Heart Disease in Adolescents and Adults ((CHDAA))

  • 906 Accesses

Abstract

There are currently more adults than children with congenital heart disease. ACHD patients are surviving into adulthood with a myriad of potential problems related not only to the primary cardiac disease but also to comorbidities and acquired illnesses. This, allied to a complex psychosocial landscape and neurodevelopmental disturbances, makes it vital for inter- and transdisciplinary teams to collaborate in highly reliable medical environments in order to provide a tailored and consistently high level of safe and efficient care. Goal-oriented therapy for ACHD patients admitted to the intensive care environment needs appropriate and reliable monitoring tool and strategies. This chapter overviews the currently available monitoring technologies utilized to efficiently monitor critically ill ACHD.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Moodie DS, Ritter DG, Tajik AJ, O'Fallon WM. Long-term follow-up in the unoperated univentricular heart. Am J Cardiol. 1984;53(8):1124–8.

    Article  CAS  Google Scholar 

  2. Ammash NM, Warnes CA. Survival into adulthood of patients with unoperated single ventricle. Am J Cardiol. 1996;77(7):542–4.

    Article  CAS  Google Scholar 

  3. Kaemmerer H, Mebus S, Schulze-Neick I, Eicken A, Trindade PT, Hager A, Oechslin E, Niwa K, Lang I, Hess J. The adult patient with Eisenmenger syndrome: a medical update after Dana point the adult patient with Eisenmenger syndrome: part I: epidemiology, clinical aspects and diagnostic options. Curr Cardiol Rev. 2010;6:343.

    Article  Google Scholar 

  4. Kidd L, Driscoll DJ, Gersony WM, et al. Second natural history study of congenital heart defects. Results of treatment of patients with ventricular septal defects. Circulation. 1993;87(Suppl):138–51.

    Google Scholar 

  5. Saha A, Balakrishnan KG, Jaiswal PK, et al. Prognosis for patient with Eisenmenger syndrome of various aetiology. Int J Cardiol. 1994;45(3):199–207.

    Article  CAS  Google Scholar 

  6. Galiè N, Beghetti M, Gatzoulis MA, Granton J, Berger RMF, Lauer A, Chiossi E, Landzberg M. Bosentan therapy in patients with Eisenmenger syndrome. Circulation. 2006;114:48–54.

    Article  Google Scholar 

  7. Adriaenssens T, Delcroix M, Van Deyk K, Budts W. Advanced therapy may delay the need for transplantation in patients with the Eisenmenger syndrome. Eur Heart J. 2006;27(12):1472–7.

    Article  CAS  Google Scholar 

  8. Braverman AC, Güven H, Beardslee MA, Makan M, Kates AM, Moon MR. The bicuspid aortic valve. Curr Probl Cardiol. 2005;30(9):470–522.

    Article  Google Scholar 

  9. Niaz T, Poterucha JT, Johnson JN, Craviari C, Nienaber T, Palfreeman J, Cetta F, Hagler DJ. Incidence, morphology, and progression of bicuspid aortic valve in pediatric and young adult subjects with coexisting congenital heart defects. Congenit Heart Dis. 2017;12(3):261–9. https://doi.org/10.1111/chd.12429.

    Article  PubMed  Google Scholar 

  10. Vonder Muhll IF, Sehgal T, Ian Paterson D. The adult with repaired coarctation: need for lifelong surveillance. Can J Cardiol. 2016;32:1038.e11.

    Article  Google Scholar 

  11. Torok RD, Campbell MJ, Fleming GA, Hill KD. Coarctation of the aorta: management from infancy to adulthood. World J Cardiol. 2015;7(11):765–75.

    Article  Google Scholar 

  12. Roifman I, Therrien J, Ionescu-Ittu R, Pilote L, Guo L, Kotowycz MA, Martucci G, Marelli AJ. Coarctation of the aorta and coronary artery disease fact or fiction? Circulation. 2012;126:16–21.

    Article  Google Scholar 

  13. Cuypers JAAE, Menting ME, Konings EEM, Opić P, Utens EMWJ, Helbing WA, Witsenburg M, van den Bosch AE, Ouhlous M, van Domburg RT, Rizopoulos D, Meijboom FJ, Boersma E, Bogers AJJC, Roos-Hesselink JW. Unnatural history of tetralogy of Fallot prospective follow-up of 40 years after surgical correction. Circulation. 2014;130:1944–53.

    Article  Google Scholar 

  14. Dennis M, Moore B, Kotchetkova I, Pressley L, Cordina R, Celermajer DS. Adults with repaired tetralogy: low mortality but high morbidity up to middle age. Open Heart. 2017;4:e000564.

    Article  Google Scholar 

  15. Knauth AL, Gauvreau K, Powell AJ, Landzberg MJ, Walsh EP, Lock JE, del Nido PJ, Geva T. Ventricular size and function assessed by cardiac MRI predict major adverse clinical outcomes late after tetralogy of Fallot repair. Heart. 2008;94:211–6. https://doi.org/10.1136/hrt.2006.104745.

    Article  CAS  PubMed  Google Scholar 

  16. Dobbels B, Herregods M-C, Troosta E, Van De Bruaene A, Rega F, Budts W, De Meester P. Early versus late pulmonary valve replacement in patients with transannular patch-repaired tetralogy of Fallot. Interact Cardiovasc Thorac Surg. 2017;25:427–33.

    Article  Google Scholar 

  17. Haeffele C, Lui GK. Dextro-transposition of the great arteries long-term sequelae of atrial and arterial switch. Cardiol Clin. 2015;33:543–58.

    Article  Google Scholar 

  18. Sarkar D, Bull C, Yates R, Wright D, Cullen S, Gewillig M, Clayton R, Tunstill A, Deanfield J. Comparison of long-term outcomes of atrial repair of simple transposition with implications for a late arterial switch strategy. Circulation. 1999;100(Suppl II):II-176–81.

    Google Scholar 

  19. Kammeraad JAE, van Deurzen CHM, Sreeram N, Bink-Boelkens MTE, Ottenkamp J, Helbing WA, Lam J, Sobotka-Plojhar MA, Balaji ODS. Predictors of sudden cardiac death after mustard or Senning repair for transposition of the great arteries. J Am Coll Cardiol. 2004;44:1095–102.

    Article  Google Scholar 

  20. Lui GK, Fernandes S, McElhinney DB. Management of cardiovascular risk factors in adults with congenital heart disease. J Am Heart Assoc. 2014;3:e001076.

    Article  Google Scholar 

  21. Schwartz ML, Gauvreau K, del Nido P, Mayer JE, Colan SD. Long-term predictors of aortic root dilation and aortic regurgitation after arterial switch operation. Circulation. 2004;110(Suppl II):II-128–32.

    Google Scholar 

  22. Safi LM, Bhatt AB. Update on the management of adults with arterial switch procedure for transposition of the great arteries. Curr Treat Options Cardiovasc Med. 2017;19:4.

    Article  Google Scholar 

  23. Flack EC, Kaushik N, Graham TP. Congenitally corrected transposition of the great arteries (Chapter 7). In: Vijayalakshmi IB, Syamasundar Rao P, Chugh R, editors. A comprehensive approach to congenital heart disease. 1st ed. New Delhi: Jaypee Brothers Medical Publishers; 2013. isbn:978-93-5090-267-7.

    Google Scholar 

  24. Graham TP Jr, Bernard YD, Mellen BG, Celermajer D, Baumgartner H, Cetta F, Connolly HM, Davidson WR, Dellborg M, Foster E, Gersony WM, Gessner IH, Hurwitz RA, Kaemmerer H, Kugler JD, Murphy DJ, Noonan JA, Morris C, Perloff JK, Sanders SP, Sutherland JL. Long-term outcome in congenitally corrected transposition of the great arteries: a multi-institutional study. J Am Coll Cardiol. 2000;36(1):255–61.

    Article  Google Scholar 

  25. Monnet X, Teboul JL, Richard C. Cardiopulmonary interactions in patients with heart failure. Curr Opin Crit Care. 2007;13(1):6–11.

    Article  Google Scholar 

  26. Bojan M, Gioanni S, Mauriat P, Pouard P. High-frequency oscillatory ventilation and short-term outcome in neonates and infants undergoing cardiac surgery: a propensity score analysis. Crit Care. 2011;15(5):R259.

    Article  Google Scholar 

  27. Valika AA, Costanzo MR. The acute cardiorenal syndrome type I: considerations on physiology, epidemiology, and therapy. Curr Heart Fail Rep. 2014;11(4):382–92.

    Article  CAS  Google Scholar 

  28. Pickering JW, James MT, Palmer SC. Acute kidney injury and prognosis after cardiopulmonary bypass: a meta-analysis of cohort studies. Am J Kidney Dis Off J Natl Kidney Found. 2015;65(2):283–93.

    Article  Google Scholar 

  29. Mariscalco G, Lorusso R, Dominici C, Renzulli A, Sala A. Acute kidney injury: a relevant complication after cardiac surgery. Ann Thorac Surg. 2011;92(4):1539–47.

    Article  Google Scholar 

  30. De Vecchis R, Esposito C, Ariano C. Efficacy and safety assessment of isolated ultrafiltration compared to intravenous diuretics for acutely decompensated heart failure: a systematic review with meta-analysis. Minerva Cardioangiol. 2014;62(2):131–46.

    PubMed  Google Scholar 

  31. Bojan M, Gioanni S, Vouhé PR, Journois D, Pouard P. Early initiation of peritoneal dialysis in neonates and infants with acute kidney injury following cardiac surgery is associated with a significant decrease in mortality. Kidney Int. 2012;82(4):474–81.

    Article  CAS  Google Scholar 

  32. Ronco C, Ricci Z, Goldstein SL. (R)evolution in the management of acute kidney injury in newborns. Am J Kidney Dis Off J Natl Kidney Found. 2015;66(2):206–11.

    Article  Google Scholar 

  33. May L, Longhurst CA, Pageler NM, Wood MS, Sharek PJ, Zebrack CM. Optimizing care of adults with congenital heart disease in a pediatric cardiovascular ICU using electronic clinical decision support. Pediatr Crit Care Med. 2014;15(5):428–34.

    Article  Google Scholar 

  34. Huygh J, Peeters Y, Bernards J, Malbrain MLNG. REVIEW. Hemodynamic monitoring in the critically ill: an overview of current cardiac output monitoring methods. F1000Research. 2855;5(F1000 Faculty Rev):2016.

    Google Scholar 

  35. Poets CF, Southall DP. Noninvasive monitoring of oxygenation in infants and children: practical considerations and areas of concern. Pediatrics. 1994;93(5):737–46.

    CAS  PubMed  Google Scholar 

  36. Tavernier B, Makhotine O, Lebuffe G, Dupont J, Scherpereel P. Systolic pressure variation as a guide to fluid therapy in patients with sepsis-induced hypotension. Anesthesiology. 1998;89(6):1313–21.

    Article  CAS  Google Scholar 

  37. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345(19):1368–77.

    Article  CAS  Google Scholar 

  38. Kern JW, Shoemaker WC. Meta-analysis of hemodynamic optimization in high-risk patients. Crit Care Med. 2002;30(8):1686–92.

    Article  Google Scholar 

  39. Swan HJ, Ganz W, Forrester J, et al. Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. N Engl J Med. 1970;283(9):447–51.

    Article  CAS  Google Scholar 

  40. Vermeij CG, Feenstra BW, Adrichem WJ, Bruining HA. Independent oxygen uptake and oxygen delivery in septic and postoperative patients. Chest. 1991;99(6):1438.

    Article  CAS  Google Scholar 

  41. Marik PE, Cavallazzi R, Vasu T, Hirani A. Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature. Crit Care Med. 2009;37(9):2642–7.

    Article  Google Scholar 

  42. Boyle M, Lawrence J, Belessis A, Murgo M, Shehabi Y. Comparison of dynamic measurements of pulse contour with pulsed heat continuous cardiac output in postoperative cardiac surgical patients. Aust Crit Care. 2007;20(1):27–32.

    Article  Google Scholar 

  43. Dark PM, Singer M. The validity of trans-esophageal Doppler ultrasonography as a measure of cardiac output in critically ill adults. Intensive Care Med. 2004;30(11):2060–6.

    Article  Google Scholar 

  44. Manasia AR, Nagaraj HM, Kodali RB, et al. Feasibility and potential clinical utility of goal-directed transthoracic echocardiography performed by noncardiologist intensivists using a small hand-carried device (SonoHeart) in critically ill patients. J Cardiothorac Vasc Anesth. 2005;19(2):155–9.

    Article  Google Scholar 

  45. Shoemaker WC, Beizberg H, Wo CC, et al. Multicenter study of noninvasive monitoring systems as alternatives to invasive monitoring of acutely ill emergency patients. Chest. 1998;114(6):1643–52.

    Article  CAS  Google Scholar 

  46. Porter JM, Swain ID. Measurement of cardiac output by electrical impedance plethysmograph. J Biomed Eng. 1987;9(3):222–31.

    Article  CAS  Google Scholar 

  47. Gomez H, Torres A, Polanco P, et al. Use of non-invasive NIRS during a vascular occlusion test to assess dynamic tissue O2 saturation response. Intensive Care Med. 2008;34(9):1600–7.

    Article  Google Scholar 

  48. Santora RJ, Moore FA. Monitoring trauma and intensive care unit resuscitation with tissue hemoglobin oxygen saturation. Crit Care. 2009;13(Suppl 5):S10.

    Article  Google Scholar 

  49. Bhalala US, Nishisaki A, McQueen D, Bird GL, Morrison WE, Nadkarni VM, Nathan M, Starr JP. Change in regional (somatic) near-infrared spectroscopy is not a useful indicator of clinically detectable low cardiac output in children after surgery for congenital heart defects. Pediatr Crit Care Med. 2012;13(5):529–34.

    Article  Google Scholar 

  50. Monthé-Sagan K, Fischer MO, Saplacan V, Gerard JL, Hanouz JL, Fellahi JL. Near-infrared spectroscopy to assess microvascular dysfunction: a prospective pilot study in cardiac surgery patients. J Crit Care. 2016;31(1):264–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cardiac Intensive Care Division, Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Joan Sánchez-de-Toledo & Lucas Sáenz

  2. Department of Pediatric Cardiology, Hospital Sant Joan de Déu, Barcelona, Spain

    Joan Sánchez-de-Toledo

  3. Department of Cardiovascular Surgery and Adult Cardiac Intensive Care Unit, Hospital Clínic, Barcelona, Spain

    Daniel Pereda

Authors
  1. Joan Sánchez-de-Toledo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lucas Sáenz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniel Pereda
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Children’s Hospital Colorado, University of Colorado Denver, Aurora, CO, USA

    Eduardo da Cruz

  2. Pediatric Intensive Care, Royal Brompton & Harefield NHS Foundation Trust, London, UK

    Duncan Macrae

  3. Adult Congenital Heart Program, Heart Institute, Cincinnati Children Hospital Medical Center, Cincinnati, OH, USA

    Gary Webb

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sánchez-de-Toledo, J., Sáenz, L., Pereda, D. (2019). General Intensive Care Monitoring and Management. In: da Cruz, E., Macrae, D., Webb, G. (eds) Intensive Care of the Adult with Congenital Heart Disease. Congenital Heart Disease in Adolescents and Adults. Springer, Cham. https://doi.org/10.1007/978-3-319-94171-4_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-94171-4_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-94170-7

  • Online ISBN: 978-3-319-94171-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation