Complications during anaesthesia for diagnostic and interventional cardiac procedures in children with congenital heart defects
Swiatnicka-Lucińska, M.łg.; Markiewicz, M.ł; Moszura, T.; Krajewski, W.
Anestezjologia Intensywna Terapia 41(3): 130-134
2009
ISSN/ISBN: 0209-1712 PMID: 19999597 Document Number: 632760
Statistics on tuberculosis (TB) in foreigners have been obtained since 1998 in Japan. The number of foreign TB patients increased from 739 in 1998 to 945 in 2008. In contrast, the number of Japanese TB patients decreased during this period and hence the proportion of foreign TB patients increased from 2.1% in 1998 to 3.9% in 2008, excluding those of unknown nationality. Especially, the proportion of those aged 20-29 years increased greatly from 9.1% in 1998 to 26.3% in 2008. Although the number of nationalities was 47, the majority of patients were from China (27.7%), the Philippines (24.8%) and Korea (10.2%) in 2008. The number of foreign TB patients aged 20-29 years was 468, accounting for 49.5% of all foreign TB patients in 2008. Seventy-seven percent of foreign patients aged 20-29 years had developed TB within 5 years of entering Japan. The equivalent proportion was 49% of those aged 30-39 years and 32% of those aged 40-49 years. Regarding occupation, 39.7% of foreign patients aged 20-29 years were full-time workers, 28.6% were students and 13.7% were part-time workers. Cardiac catheterisation, while enabling dynamic evaluation of the cardiovascular system, is also commonly performed for interventional procedures in all age groups. The aim of this study was to analyse the incidence and spectrum of complications occurring during general anaesthesia in children undergoing cardiac catheterisation. We retrospectively reviewed the medical charts of 1622 consecutive patients, anaesthetised for 817 diagnostic, and 805 interventional cardiac procedures. Data on patient- and procedure-related variables affecting the risk of complications was collected. We analysed the influence of age, physical status, type of heart defect, type of procedure, and anaesthetic protocol on the incidence of complications. Serious complications occurred in 5 patients undergoing diagnostic procedures and in 24 undergoing interventional procedures, with infants being the most affected (21 cases). The most frequent complication was acute heart failure related to the catheterisation. In 2 cases, pneumothorax followed central venous catheter insertion. There were 14 cardiac arrests requiring cardiopulmonary resuscitation, resulting in three deaths. The results show that diagnostic cardiac catheterisation and interventional procedures are associated with a low risk of complications (1.78%) and a low mortality rate (0.18%).