https://scholars.lib.ntu.edu.tw/handle/123456789/462552
標題: | Anaesthetic managements for conjoined twins with complex cardiac anomalies | 作者: | Chen T.-L. Lin C.-J. HONG-SHIEE LAI Chen W.-J. Chao C.-C. Liu C.-C. |
關鍵字: | Anaesthesia, paediatric; Congenital anomaly, cardiac; Twins, conjoined | 公開日期: | 1996 | 出版社: | Springer New York LLC | 卷: | 43 | 期: | 11 | 起(迄)頁: | 1161-1167 | 來源出版物: | Canadian Journal of Anaesthesia | 摘要: | Purpose: To describe the perioperative assessment and anaesthetic management for surgical separation of three sets of conjoined twins with complex cardiac anomalies threatened with arterial desaturation and haemodynamic instability. Clinical features: Three sets of conjoined twins, one omphaloischiopagus, one omphalopagus, and one thoraco-omphalopagus, were considered for separation during the perinatal or infantile period. Preoperative functional evaluation including continuous pulse oximetry, capnography, and cardiac electrophysiological studies were considered to be as important as anatomical evaluation of the cardiac anomalies and cross-circulation by angiography in assessing the feasibility of surgical separation. Ipsilateral infusion of prostaglandin E1 and phenylephrine were applied to the cyanotic and healthy twins respectively, to restore arterial oxygenation intraoperatively and to avoid profound hypoxaemia. Conclusion: Surgical separation and anaesthesia should be well planned and rehearsed before clinical deterioration of the weaker twin. Aggressive pharmacological intervention and understanding of the cross-circulation pathophysiology is necessary to manage critical situations during surgical separation and in the postoperative period. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0030484397&doi=10.1007%2fBF03011846&partnerID=40&md5=2a4ec602fa7df19b2d3dae691f342531 https://scholars.lib.ntu.edu.tw/handle/123456789/462552 |
ISSN: | 0832-610X | DOI: | 10.1007/BF03011846 | SDG/關鍵字: | article; case report; congenital heart malformation; conjoined twins; general anesthesia; human; infant; medical assessment; pathophysiology; pediatric anesthesia; postoperative period; priority journal; surgical technique |
顯示於: | 醫學系 |
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