Anesthesia and Respiratory Support

  • J. T. Davidson
  • S. Cotev


In this chapter some aspects of anesthetic care in aquired valvular heart disease in children are discussed to stress the totality of the role of the anesthesiologist in the medical team.


Valve Replacement Rheumatic Heart Disease Constrictive Pericarditis Mitral Valve Disease Pulmonary Dysfunction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Temple LJ Richardson JC (1972) Acquired cardiac abnormalities: Surgical treatment with notes on anaesthetic management In: Gray TC Nunn JF (eds) General Anaesthesia, 3rd edn. Vol II. Butterworths, London, p 236Google Scholar
  2. 2.
    White RD, Tarhan S (1974) Anesthetic aspects of cardiac surgery. A review of clinical management. Anesth Analg (Cleve) 53:98Google Scholar
  3. 3.
    Branthwaite MA (1977) Anaesthesia for Cardiac Surgery and Allied Procedures. Blackwell Scientific Publications, Oxford London Edinburgh MelbourneGoogle Scholar
  4. 4.
    Churchill Davidson HC (1978) Anaesthesia and cardiac disease. In: A Practice of Anaesthesia, 4th edn. Lloyd Luke (Medical Books), London, p 530Google Scholar
  5. 5.
    Kampschulte S, Safar P (1973) Development of a multidisciplinary pediatric intensive care unit. Crit Care Med 1:308PubMedCrossRefGoogle Scholar
  6. 6.
    Mellins RB, Chernick V, Doershuk CF, Downes JJ, Sinclair JC, Waring WW (1972) Committee report: Respiratory care in infants and children. Am Rev Respir Dis 105:461PubMedGoogle Scholar
  7. 7.
    Jordan SC, Scott O (1973) Heart Disease in Paediatrics. Butterworths, London, p 249Google Scholar
  8. 8.
    Perry CB (1969) The natural history of acute rheumatism. Ann Rheum Dis 28:471PubMedCrossRefGoogle Scholar
  9. 9.
    Borman JB Simcha A Milwidsky A, Davidson JT, Tzivoni D, Gotsman MS (1975) Long-term results of valve replacement in children suffering from rheumatic heart disease. Isr J Med Sci 11:144PubMedGoogle Scholar
  10. 10.
    Kempe HC, Silver HK, O’Brien D (1974) Current Pediatric Diagnosis and Treatment, 3rd edn. Los Altos, California, p 337Google Scholar
  11. 11.
    Shulman JL, Foley JM, Vernon DT (1967) A study on the effect of the mother’s presence during anesthesia induction. Pediatrics 39:111Google Scholar
  12. 12.
    Jessner L Blom GE, Waldfogel S (1957) Emotional implication of tonsillectomy and adenoid-ectomy on children. Psychoanal Study Child VII: 126Google Scholar
  13. 13.
    Bothe A, Galdston R (1972) The child’s loss of consciousness: A psychiatric view of pediatric anesthesia Pediatrics 50:252Google Scholar
  14. 14.
    Smith RM (1949) Methods of induction in pediatric anesthesia. N Engl J Med 240:761PubMedCrossRefGoogle Scholar
  15. 15.
    Daly WJ, Giammona ST Ross JC, Feigenbaum H (1964) Effect of pulmonary vascular congestion on postural changes in the perfusion and filling of the pulmonary vascular bed. J Clin Invest 43:68PubMedCrossRefGoogle Scholar
  16. 16.
    Gazetopoulos N, Davies H Oliver C, Deuchar D (1966) Ventilation and hemodynamics in heart disease Br Heart J 28:1Google Scholar
  17. 17.
    Sharp JT, Griffith GT Bunnell IL, Greene DG (1958) Ventilatory mechanics in pulmonary edema in man. J Clin Invest 37:111PubMedCrossRefGoogle Scholar
  18. 18.
    Bates DV, Christie RV (1964) Respiratory Function in Disease. Saunders, Philadelphia, p 332Google Scholar
  19. 19.
    McCredie M (1967) Measurement of pulmonary edema in valvular heart disease. Circulation 36:381PubMedGoogle Scholar
  20. 20.
    Klein E, Uretsky G, Davidson JT, Borman JB (1977) Preoperative intermittent positive pressure respiration as preparation for emergency valvular surgery for pulmonary edema. Isr J Med Sci 13:1211PubMedGoogle Scholar
  21. 21.
    Yu PN (1969) Pulmonary Blood Volume in Health and Disease. Lea & Febiger, Philadelphia, p 285Google Scholar
  22. 22.
    Schamroth L, Krikler DM, Garret T (1972) Immediate effects of intravenous verapamil in cardiac arrhythmias. Br Med J 1:660PubMedCrossRefGoogle Scholar
  23. 23.
    Brichard G, Zimmerman PE (1970) Verapamil in cardiac dysrhythmias during anaesthesia. Br JAnaesth 42:1005CrossRefGoogle Scholar
  24. 24.
    Ross G, Jorgensen CR (1967) Cardiovascular actions of iproveratril. J Pharmacol Exp Ther 158 504PubMedGoogle Scholar
  25. 25.
    Hilla EA (1970) Iproveratril and bronchial asthma. Br J Clin Pract 24:116Google Scholar
  26. 26.
    Price HL (1961) Circulatory actions of general anesthetic agents and the homeostatic roles of epinephrine and norepmephrine in man. Clin Pharmacol Ther 2:163PubMedGoogle Scholar
  27. 27.
    Price HL, Linde HW, Jones RE, Black GW, Price ML (1959) Sympathoadrenal responses to general anesthesia in man and their relation to hemodynamics. Anesthesiology 20:563PubMedCrossRefGoogle Scholar
  28. 28.
    Etsten B, Li TH (1962) Current concepts of myocardial function during anaesthesia. Br J Anaesth 34:884CrossRefGoogle Scholar
  29. 29.
    Shimosato S, Li TH, Etsten B (1963) Ventricular functions during halothane anaesthesia in closed chest dogs. Cire Res 12:63Google Scholar
  30. 30.
    Lurie AA, Jones RE, Linde HW, Price ML, Drips RD, Price HL (1958) Cyclopropane anesthesia. I. Cardiac rate and rhythm during steady state levels of cyclopropane anesthesia at normal and elevated end-expiratory carbon dioxide tensions. Anesthesiology 19:457PubMedCrossRefGoogle Scholar
  31. 31.
    Price HL, Lurie AA, Jones RE, Price ML, Linde HL (1958) Cyclopropane anesthesia. II. Epinephrine in initiating of ventricular arrhythmias by carbon dioxide inhalation. Anesthesiology 19:619PubMedCrossRefGoogle Scholar
  32. 32.
    Virtue RW, Alanis JM Mori M, Lafargue M, Vogel M, Metcalf DR (1967) An anesthetic agent: orthochlorophenyl 2-methylamino cyclohexanone HCl (CI-581). Anesthesiology 28:823PubMedCrossRefGoogle Scholar
  33. 33.
    Traber DL, Wilson RD, Priano LL (1968) Differentiation of the cardiovascular effects of CI-581. Anesth Analg (Cleve) 47:769Google Scholar
  34. 34.
    Bovil JG, Clarke RSJ, Davis EA, Dundee JW (1971) Some cardiovascular effects of ketamine in man. Br J Pharmacol 41:411Google Scholar
  35. 35.
    Hunter AR (1972) In Hewer CL (ed) Recent Advances in Anaesthesia and Analgesia. McGraw-Hill, Livingstone Edinburgh, p 4Google Scholar
  36. 36.
    Dowdy EG, Kaya K (1968) Studies in the mechanism of cardiovascular responses to Cl-581. Anesthesiology 29:931PubMedCrossRefGoogle Scholar
  37. 37.
    Goldberg AH Keane RW, Phear WPC (1969) Effects of ketamine on contractile behaviour of isolated heart muscles. Abstr. Scientific Papers Amer Soc Anesth Annual Meeting 1969Google Scholar
  38. 38.
    Corssen G, Allarde R, Brosch F Arbenz G (1970) Ketamine as the sole anesthetic in open-heart surgery. Anesth Analg (Cleve) 49:1025Google Scholar
  39. 39.
    Vaughan RW, Stephen CR (1973) Ketamine for corrective cardiac surgery in children. South Med J 66:1226PubMedCrossRefGoogle Scholar
  40. 40.
    Radnay PA, Hollinger I, Santi A, Nagashima H (1976) Ketamine for pediatric cardiac anesthesia. Anaesthetist 25:99Google Scholar
  41. 41.
    King CH, Stephen CR (1967) A new intravenous or intramuscular anesthetic. Anesthesiology 28:258CrossRefGoogle Scholar
  42. 42.
    Perel A, Davidson JT (1976) Recurrent hallucinations following ketamine. Anaesthesia 31:1081PubMedCrossRefGoogle Scholar
  43. 43.
    Baird WLM, Reid AM (1967) The neuromuscular blocking properties of a new steroid compound, pancuronium bromide. Br J Anaesth 39:775PubMedCrossRefGoogle Scholar
  44. 44.
    Lippmann M, Rogoff RC (1974) Clinical experience with pancuronium bromide in children. Anesth Analg 53:684PubMedGoogle Scholar
  45. 45.
    Leigh MD, McCoy DD, Belton MK, Lewis GB (1957) Bradycardia following intravenous administration of succinylcholine chloride to infants and children. Anesthesiology 18:698PubMedCrossRefGoogle Scholar
  46. 46.
    Bennett EJ, Daughety MJ Bower DE, Stephan CR (1971) Pancuronium bromide experiences in 100 pediatric patients. Anesth Analg 50:798PubMedCrossRefGoogle Scholar
  47. 47.
    Kelman GR, Kennedy BB (1971) Cardiovascular effects of pancuronium in man. Br J Anaesth 43:335PubMedCrossRefGoogle Scholar
  48. 48.
    Foldes FF (1972) The rational use of neuromuscular blocking agents: The role of pancuronium. Drugs 4:153PubMedCrossRefGoogle Scholar
  49. 49.
    Speight TM, Avery GS (1972) Pancuronium bromide. A review of its pharmacological properties and clinical application. Drugs 4:163PubMedCrossRefGoogle Scholar
  50. 50.
    Coleman AJ, Downing JW, Leary WP, Moyes DG, Styles M (1972) The immediate cardiovascular effects of pancuronium, alcuronium and tubocurarine in man. Anaesthesia 27:415PubMedCrossRefGoogle Scholar
  51. 51.
    Geddes IC, Gray TC (1959) Hyperventilation for the maintenance of anaesthesia. Lancet 11:4CrossRefGoogle Scholar
  52. 52.
    Clutton-Brock J (1957) The cerebral effects of overventilation. Br J Anaesth 29:111PubMedCrossRefGoogle Scholar
  53. 53.
    Robinson JS, Gray TC (1961) Observations on the cerebral effects of passive hyperventilation. Br J Anaesth 33:62PubMedCrossRefGoogle Scholar
  54. 54.
    Severinghaus JW (1966) Blood gas calculator. J Appl Physiol 21:1108PubMedGoogle Scholar
  55. 55.
    Forrest JB (1972) The effect of hyperventilation on pulmonary surface activity. Br J Anaesth 44:313PubMedCrossRefGoogle Scholar
  56. 56.
    Trimble C, Smith DE, Rosenthal MH, Fosburg RG (1971) Pathophysiologic role of hypo-carbia in post-traumatic pulmonary insufficiency. Am J Surg 122:633PubMedCrossRefGoogle Scholar
  57. 57.
    Khambatta HJ, Sullivan SF (1973) Effects of respiratory alkalosis on oxygen consumption and oxygenation. Anesthesiology 38:53PubMedCrossRefGoogle Scholar
  58. 58.
    Lowenstein E, Hallowell P, Levine FH, Daggett WM, Austen WG, Laver MB (1969) Cardiovascular response to large doses of intravenous morphine in man. N Engl J Med 281:1389PubMedCrossRefGoogle Scholar
  59. 59.
    Hasbrouck JD (1970) Morphine anesthesia for open heart surgery. Ann Thorac Surg 10:364PubMedCrossRefGoogle Scholar
  60. 60.
    Poppers PJ, Epstein RM, Donham RT (1971) Automatic ultrasound monitoring of blood pressure during induced hypotension. Anesthesiology 35:431PubMedCrossRefGoogle Scholar
  61. 61.
    Andersen NB, Ghia J (1970) Pulmonary function, cardiac status, and post-operative course in relation to cardiopulmonary bypass. J Thorac Cardiovasc Surg 59:474PubMedGoogle Scholar
  62. 62.
    Hedley-Whyte J, Corning H, Laver MB, Austen WG, Bendixen HH (1965) Pulmonary ventilation-perfusion relations after heart valve replacement or repair in man. J Clin Invest 44:406PubMedCrossRefGoogle Scholar
  63. 63.
    McClanahan JB, Young WE, Sykes MK (1965) Respiratory changes after open heart surgery. Thorax 20:545CrossRefGoogle Scholar
  64. 64.
    Laver MB, Hallowell P, Goldblatt A (1970) Pulmonary dysfunction secondary to heart disease: Aspects relevant to anesthesia and surgery. Anesthesiology 33:161PubMedCrossRefGoogle Scholar
  65. 65.
    Pennock JL, Pierce WS, Waldhausen JA (1977) The management of the lungs during cardiopulmonary bypass. Surg Gynecol Obstet 145:917PubMedGoogle Scholar
  66. 66.
    Sykes MK, Adams AP, McCormick PW, Bird B, Greenburgh S (1970) The effect of mechanical ventilation after open-heart surgery. Anaesthesia 25:525PubMedCrossRefGoogle Scholar
  67. 67.
    Kaplan SL, Sullivan SF, Malm JR, Bowman FO, Papper EM (1969) Effect of cardiac bypass on pulmonary diffusing capacity. J Thorac Cardiovasc Surg 57:738PubMedGoogle Scholar
  68. 68.
    Asada S, Yamaguchi M (1971) Fine structural changes in the lung following cardiopulmonary bypass. Chest 59:478PubMedCrossRefGoogle Scholar
  69. 69.
    Ratliff NB, Young WG, Hackel DB, Mikat E, Wilson JW (1973) Pulmonary injury secondary to extracorporeal circulation. An ultrastructural study. J Thorac Cardiovasc Surg 65:425PubMedGoogle Scholar
  70. 70.
    Ghia J, Andersen NB (1970) Pulmonary function and cardiopulmonary bypass. JAMA 212:593PubMedCrossRefGoogle Scholar
  71. 71.
    Tarhan S, Moffitt EA (1971) Anesthesia and supportive care during and after cardiac surgery. Ann Thorac Surg 11:64PubMedCrossRefGoogle Scholar
  72. 72.
    Prakash O, Jonson B, Meij S, Bos E, Hugenholtz PG, Nauta J, Hekman W (1977) Criteria for early extubation after intracardiac surgery in adults. Anesth Analg 56:703PubMedCrossRefGoogle Scholar
  73. 73.
    Dollery CT, West JB (1960) Regional uptake of radioactive oxygen, carbon monoxide and carbon dioxide in the lungs of patients with mitral stenosis. Circ Res 8:765PubMedGoogle Scholar
  74. 74.
    Carroll D, Cohn JE, Riley RL (1953) Pulmonary function in mitral valvular disease: distribution and diffusion characteristics in resting patients. J Clin Invest 32:510PubMedCrossRefGoogle Scholar
  75. 75.
    Sanders CA, Harthorne JW, Heitman H, Laver MB (1965) Effect of vasopressor administration on blood gas exchange in mitral disease (abstract). Clin Res 13:351Google Scholar
  76. 76.
    Brigham, KL, Faulkner SL, Fisher RD, Bender HW (1976) Lung water and urea indicator dilution studies in cardiac surgery patients. Circulation 53:369PubMedGoogle Scholar
  77. 77.
    Cortese DA (1978) Pulmonary function in mitral stenosis. Mayo Clin Proc 53:321PubMedGoogle Scholar
  78. 78.
    Vidne BA, Lajos TZ, Sayek I, Friedman I, Stoklosa J, Shenoy S, Culver G (1976) Postperfusion lung syndrome. NY State J Med 76:684Google Scholar
  79. 79.
    Ashbaugh DG, Petty TL (1973) Positive end-expiratory pressure. J Thorac Cardiovasc Surg 65:165PubMedGoogle Scholar
  80. 80.
    Powers SR (1974) The use of positive end-expiratory pressure (PEEP) for respiratory support. Surg Clin North Am 54:1125PubMedGoogle Scholar
  81. 81.
    Kumar A, Falke KJ, Geffin B, Aldridge CF Laver MB, Lowenstein E, Pontoppidan H (1970) Continuous positive-pressure ventilation in acute respiratory failure. N Engl J Med 283:1430PubMedCrossRefGoogle Scholar
  82. 82.
    Kusajima K, Webb WR, Parker FB, Bredenberg CE, Markarian B (1975) Pulmonary response of unilateral positive end-expiratory pressure (PEEP) on experimental fat embolism. Ann Surg 181:676PubMedCrossRefGoogle Scholar
  83. 83.
    Sykes MK, Adams AP, Finley WEI, McCormick PW, Economides A (1970) The effects of variations in end expiratory inflation pressure on cardiorespiratory function in normo-, hypo-, and hypervolaemic dogs. Br J Anaesth 42:669PubMedCrossRefGoogle Scholar
  84. 84.
    Toung TJK, Saharia P, Mitzner WA, Permutt S. Cameron JL (1978) The beneficial and harmful effects of positive end-expiratory pressure. Surg Gynecol Obstet 147:518PubMedGoogle Scholar
  85. 85.
    Harken AH, Brennan MF, Smith B, Barsamian EM (1974) The hemodynamic response to positive end-expiratory ventilation in hypovolemic patients. Surgery 76:786PubMedGoogle Scholar
  86. 86.
    Qvist J, Pontoppidan H, Wilson RS, Lowenstein E, Laver MB (1975) Hemodynamic response to mechanical ventilation with PEEP: the effect of hypervolemia. Anesthesiology 42:45PubMedCrossRefGoogle Scholar
  87. 87.
    Trichet B, Falke K, Togut A, Laver MB (1975) The effect of preexisting pulmonary vascular disease on the response to mechanical ventilation with PEEP following open heart surgery. Anesthesiology 42:56PubMedCrossRefGoogle Scholar
  88. 88.
    Downs JB, Perkins HM, Modell JH (1974) Intermittent mandatory ventilation. An evaluation. Arch Surg 109:519PubMedCrossRefGoogle Scholar
  89. 89.
    Kirby RR, Perry JC, Calderwood HW, Ruiz BC, Lederman DS (1975) Cardiorespiratory effects of high positive end-expiratory pressure. Anesthesiology 43:533PubMedCrossRefGoogle Scholar
  90. 90.
    Stewart S, Edmunds LH, Kirklin JW Allarde RR (1973) Spontaneous breathing with continuous positive airway pressure after open intracardiac operations in infants. J Thorac Cardiovasc Surg 65:37PubMedGoogle Scholar
  91. 91.
    Drugge U. Norlander O, Olsson P, Radegran K (1973) Positive end-expiratory pressure-ventilation after open-heart surgery. Acta Anaesthesiol Scand (Suppl) 53:81Google Scholar
  92. 92.
    Feeley TW, Hedley-Whyte J (1975) Weaning from controlled ventilation and supplemented oxygen. N Engl J Med 292:903PubMedCrossRefGoogle Scholar
  93. 93.
    Sahn SA, Lakshminarayan S, Petty TL (1976) Weaning from mechanical ventilation. J Am Med Assoc 235:2208CrossRefGoogle Scholar
  94. 94.
    Millbern SM, Downs JB, Jumper LC, Modell JH (1978) Evaluation of criteria for discontinuing mechanical ventilatory support. Arch Surg 113:1441PubMedCrossRefGoogle Scholar
  95. 95.
    Conte JE, Cohen SN, Roe BB, Elashoff RM (1972) Antibiotic prophylaxis and cardiac surgery: A prospective double blind comparison of single-dose versus multiple-dose regimens. Ann Intern Med 76:943PubMedGoogle Scholar
  96. 96.
    Findlay CW (1971) Sepsis in the surgical intensive care unit. Med Clin North Am 55:1331PubMedGoogle Scholar
  97. 97.
    Rosendorf LL, Daicoff G, Baer H (1974) Sources of gram-negative infection after open-heart surgery. J Thorac Cardiovasc Surg 67:195PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1980

Authors and Affiliations

  • J. T. Davidson
  • S. Cotev

There are no affiliations available

Personalised recommendations