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Perioperative Respiratory Monitoring in Congenital Heart Disease Patients

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Congenital Heart Disease in Pediatric and Adult Patients

Abstract

Respiratory monitoring is one of the most important tasks in medicine; especially in critically ill patients. However, when a patient, especially a child undergoes some complex surgeries like surgery for congenital heart diseases, respiratory monitoring is much more stressed; though not such a simple task. Respiratory monitoring in congenital heart diseases starts from history taking and clinical examination to different ancillary assessment methods, including pulse oximetry, capnography, blood gas analysis, monitoring of the ventilator and mechanical ventilator support systems, and other technologies. Though we are in the era of emerging technologies, basic clinical principles are still the cornerstone of respiratory assessment. Meanwhile, age-matched trends should be considered in the assessments.

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References

  • Agha H, El Heinady F, El Falaky M, Sobih A. Pulmonary functions before and after pediatric cardiac surgery. Pediatr Cardiol. 2014;35:542–9.

    PubMed  Google Scholar 

  • Arigliani M, Zheng S, Ruiz G, Chakravorty S, Bossley CJ, Rees D, Gupta A. Comparison of pulse oximetry and earlobe blood gas with CO-oximetry in children with sickle cell disease: a retrospective review. BMJ paediatr Open. 2020;4:e000690.

    PubMed  PubMed Central  Google Scholar 

  • Auten R, Schwarze J, Ren C, Davis S, Noah TL. Pediatric pulmonology year in review 2015: part 1. Pediatr Pulmonol. 2016;51:733.

    PubMed  Google Scholar 

  • Aviles-Solis JC, Vanbelle S, Halvorsen PA, Francis N, Cals JWL, Andreeva EA, Marques A, Piirilä P, Pasterkamp H, Melbye H. International perception of lung sounds: a comparison of classification across some European borders. BMJ Open Respir Res. 2017;4:e000250.

    PubMed  PubMed Central  Google Scholar 

  • Aviles-Solis JC, Jácome C, Davidsen A, Einarsen R, Vanbelle S, Pasterkamp H, Melbye H. Prevalence and clinical associations of wheezes and crackles in the general population: the tromsø study. BMC Pulm Med. 2019;19:173.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Aviles-Solis JC, Storvoll I, Vanbelle S, Melbye H. The use of spectrograms improves the classification of wheezes and crackles in an educational setting. Sci Rep. 2020;10:8461.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Bartosh SM, Aronson AJ. Childhood hypertension. An update on etiology, diagnosis, and treatment. Pediatr Clin N Am. 1999;46:235–52.

    CAS  Google Scholar 

  • Bassareo PP, Mercuro G. Pediatric hypertension: an update on a burning problem. World J Cardiol. 2014;6:253–9.

    PubMed  PubMed Central  Google Scholar 

  • Bianco F, Salomone F, Milesi I, Murgia X, Bonelli S, Pasini E, Dellacà R, Ventura ML, Pillow J. Aerosol drug delivery to spontaneously-breathing preterm neonates: lessons learned. Respir Res. 2021;22:71.

    PubMed  PubMed Central  Google Scholar 

  • Blumenthal S, Epps RP, Heavenrich R, Lauer RM, Lieberman E, Mirkin B, Mitchell SC, Boyar Naito V, O'Hare D, McFate Smith W, Tarazi RC, Upson D. Report of the task force on blood pressure control in children. Pediatrics. 1977;59(I-ii):797–820.

    Google Scholar 

  • Bohadana A, Izbicki G, Kraman SS. Fundamentals of lung auscultation. N Engl J Med. 2014;370:744–51.

    CAS  PubMed  Google Scholar 

  • Bohadana A, Azulai H, Jarjoui A, Kalak G, Izbicki G. Influence of observer preferences and auscultatory skill on the choice of terms to describe lung sounds: a survey of staff physicians, residents and medical students. BMJ Open Respir Res. 2020;7:e000564.

    PubMed  PubMed Central  Google Scholar 

  • Bonafide CP, Brady PW, Keren R, Conway PH, Marsolo K, Daymont C. Development of heart and respiratory rate percentile curves for hospitalized children. Pediatrics. 2013;131:e1150–7.

    PubMed  PubMed Central  Google Scholar 

  • Brochard L, Martin GS, Blanch L, Pelosi P, Belda FJ, Jubran A, Gattinoni L, Mancebo J, Ranieri VM, Richard JC, Gommers D, Vieillard-Baron A, Pesenti A, Jaber S, Stenqvist O, Vincent JL. Clinical review: respiratory monitoring in the ICU—a consensus of 16. Crit Care. 2012;16:219.

    PubMed  PubMed Central  Google Scholar 

  • Bronicki RA, Anas NG. Cardiopulmonary interaction. Pediatr Crit Care Med. 2009;10:313–22.

    PubMed  Google Scholar 

  • Brzezinski WA. Blood pressure. In: Walker HK, Hall WD, Hurst JW, editors. Clinical methods: the history, physical, and laboratory examinations. Boston: Butterworths. Butterworth Publishers, a Division of Reed Publishing; 1990.

    Google Scholar 

  • Celmina M, Paule S. Stridor in children. Breathe (Sheff). 2018;14:e111–7.

    PubMed  Google Scholar 

  • Chakkarapani AA, Adappa R, Mohammad Ali SK, Gupta S, Soni NB, Chicoine L, Hummler HD. “Current concepts of mechanical ventilation in neonates”—part 1: basics. Int J Pediatr Adolesc Med. 2020;7:13–8.

    PubMed  PubMed Central  Google Scholar 

  • Challands J, Brooks K. Paediatric respiratory distress. BJA Educ. 2019;19:350–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Chen F, Bajwa NM, Rimensberger PC, Posfay-Barbe KM, Pfister RE. Thirteen-year mortality and morbidity in preterm infants in Switzerland. Arch Dis Child Fetal Neonatal Ed. 2016;101:F377.

    PubMed  Google Scholar 

  • Clarizia NA, Manlhiot C, Schwartz SM, Sivarajan VB, Maratta R, Holtby HM, Gruenwald CE, Caldarone CA, Van Arsdell GS, McCrindle BW. Improved outcomes associated with intraoperative steroid use in high-risk pediatric cardiac surgery. Ann Thorac Surg. 2011;91:1222–7.

    PubMed  Google Scholar 

  • Davis JL, Murray JF. History and physical examination. In: Murray and Nadel’s textbook of respiratory medicine. Amsterdam: Elsevier; 2016. p. 263–277.e262.

    Google Scholar 

  • Davis SQ, Permutt Z, Permutt S, Naureckas ET, Bilderback AL, Rand CS, Stein BD, Krishnan JA. Perception of airflow obstruction in patients hospitalized for acute asthma. Ann Allergy Asthma Immunol. 2009;102:455–61.

    PubMed  Google Scholar 

  • Delecaris AO, Averill SH, Krasinkiewicz J, Saunders JL, Ren CL. Pediatric pulmonology year in review 2020: physiology. Pediatr Pulmonol. 2021;56:2444–8.

    PubMed  Google Scholar 

  • Dionne JM, Abitbol CL, Flynn JT. Hypertension in infancy: diagnosis, management and outcome. Pediatr Nephrol. 2012;27:17–32.

    PubMed  Google Scholar 

  • Donoso A, Arriagada D, Contreras D, Ulloa D, Neumann M. Respiratory monitoring of pediatric patients in the intensive care unit. Bol Med Hosp Infant Mex. 2016;73:149–65.

    PubMed  Google Scholar 

  • Egbuta C, Mason KP. Recognizing risks and optimizing perioperative care to reduce respiratory complications in the pediatric patient. J Clin Med. 2020;9:1942.

    PubMed  PubMed Central  Google Scholar 

  • Elder DE, Campbell AJ, Galletly D. Current definitions for neonatal apnoea: are they evidence based? J Paediatr Child Health. 2013;49:E388–96.

    PubMed  Google Scholar 

  • Erickson G, Dobson NR, Hunt CE. Immature control of breathing and apnea of prematurity: the known and unknown. J Perinatol. 2021;41:2111–23.

    PubMed  PubMed Central  Google Scholar 

  • Feld LG, Springate JE. Hypertension in children. Curr Probl Pediatr. 1988;18:317–73.

    CAS  PubMed  Google Scholar 

  • Fleming S, Thompson M, Stevens R, Heneghan C, Pluddemann A, Maconochie I, Tarassenko L, Mant D. Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies. Lancet. 2011;377:1011–8.

    PubMed  PubMed Central  Google Scholar 

  • Gazit AZ, Huddleston CB, Checchia PA, Fehr J, Pezzella AT. Care of the pediatric cardiac surgery patient—part 2. Curr Probl Surg. 2010;47:261–376.

    PubMed  Google Scholar 

  • Herbert A, Pearn J, Wilson S. Normal percentiles for respiratory rate in children-reference ranges determined from an optical sensor. Children (Basel). 2020;7:160.

    PubMed  Google Scholar 

  • Heys M, Lin SL, Lam TH, Leung GM, Schooling CM. Lifetime growth and blood pressure in adolescence: Hong Kong’s “children of 1997” birth cohort. Pediatrics. 2013;131:e62–72.

    PubMed  Google Scholar 

  • Horan MJ, Sinaiko AR. Synopsis of the report of the second task force on blood pressure control in children. Hypertension. 1987;10:115–21.

    CAS  PubMed  Google Scholar 

  • Ingelfinger JR. Clinical practice. The child or adolescent with elevated blood pressure. N Engl J Med. 2014;370:2316–25.

    PubMed  Google Scholar 

  • Jubran A. Pulse oximetry. Crit Care. 2015;19:272.

    PubMed  PubMed Central  Google Scholar 

  • Kim Y, Hyon Y, Jung SS, Lee S, Yoo G, Chung C, Ha T. Respiratory sound classification for crackles, wheezes, and rhonchi in the clinical field using deep learning. Sci Rep. 2021;11:17186.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Magder S. Heart-lung interaction in spontaneous breathing subjects: the basics. Ann Trans Med. 2018;6:348.

    Google Scholar 

  • Mahmood SS, Pinsky MR. Heart-lung interactions during mechanical ventilation: the basics. Ann Trans Med. 2018;6:349.

    Google Scholar 

  • McCollum ED, King C, Hollowell R, Zhou J, Colbourn T, Nambiar B, Mukanga D, Burgess DC. Predictors of treatment failure for non-severe childhood pneumonia in developing countries: systematic literature review and expert survey—the first step towards a community focused mHealth risk-assessment tool? BMC Pediatr. 2015;15:74.

    PubMed  PubMed Central  Google Scholar 

  • McLain LG. Hypertension in childhood: a review. Am Heart J. 1976;92:634–47.

    CAS  PubMed  Google Scholar 

  • National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114:555–76.

    Google Scholar 

  • Oliveira A, Marques A. Respiratory sounds in healthy people: a systematic review. Respir Med. 2014;108:550–70.

    PubMed  Google Scholar 

  • Park SB, Khattar D. Tachypnea. In: StatPearls. Treasure Island, FL: StatPearls, Copyright © 2021, StatPearls Publishing LLC; 2021.

    Google Scholar 

  • Pasterkamp H, Patel S, Wodicka GR. Asymmetry of respiratory sounds and thoracic transmission. Med Biol Eng Comput. 1997;35:103–6.

    CAS  PubMed  Google Scholar 

  • Pinsky MR. The hemodynamic consequences of mechanical ventilation: an evolving story. Intensive Care Med. 1997;23:493–503.

    CAS  PubMed  Google Scholar 

  • Pinsky MR. Cardiopulmonary interactions: physiologic basis and clinical applications. Ann Am Thorac Soc. 2018;15:S45–s48.

    PubMed  PubMed Central  Google Scholar 

  • Pramono RXA, Bowyer S, Rodriguez-Villegas E. Automatic adventitious respiratory sound analysis: a systematic review. PLoS One. 2017;12:e0177926.

    PubMed  PubMed Central  Google Scholar 

  • Rettig JS, Smallwood CD, Walsh BK, Rimensberger PC, Bachman TE, Bollen CW, Duval EL, Gebistorf F, Markhorst DG, Tinnevelt M, Todd M, Zurakowski D, Arnold JH. High-frequency oscillatory ventilation in pediatric acute lung injury: a multicenter international experience. Crit Care Med. 2015;43:2660–7.

    CAS  PubMed  Google Scholar 

  • Reyes FM, Modi P, Le JK. Lung exam. In: StatPearls. Treasure Island, FL: StatPearls, Copyright © 2021, StatPearls Publishing LLC; 2021.

    Google Scholar 

  • Rimensberger PC. Mechanical ventilation in paediatric intensive care. Ann Fr Anesth Reanim. 2009a;28:682–4.

    CAS  PubMed  Google Scholar 

  • Rimensberger PC. To intubate or not to intubate at birth, this is still the question! will experimental studies give us the answer?: commentary on the article by Polglase et al. on page 67. Pediatr Res. 2009b;65:19–20.

    PubMed  Google Scholar 

  • Ross KR, Rosen CL. Sleep and respiratory physiology in children. Clin Chest Med. 2014;35:457–67.

    PubMed  Google Scholar 

  • Rossol SL, Yang JK, Toney-Noland C, Bergin J, Basavaraju C, Kumar P, Lee HC. Non-contact video-based neonatal respiratory monitoring. Children (Basel). 2020;7:171.

    PubMed  Google Scholar 

  • Röttgering JG, de Man AME, Schuurs TC, Wils EJ, Daniels JM, van den Aardweg JG, Girbes ARJ, Smulders YM. Determining a target SpO2 to maintain PaO2 within a physiological range. PLoS One. 2021;16:e0250740.

    PubMed  PubMed Central  Google Scholar 

  • Saraya T, Shimoda M, Hirata A, Takizawa H. Paradoxical respiration: ‘Seesaw’ motion with massive pulmonary consolidation. BMJ Case Rep. 2016;2016:bcr2015213449.

    PubMed  PubMed Central  Google Scholar 

  • Shah AB, Hashmi SS, Sahulee R, Pannu H, Gupta-Malhotra M. Characteristics of systemic hypertension in preterm children. J Clin Hypertens (Greenwich). 2015;17:364–70.

    PubMed  Google Scholar 

  • Shekerdemian L, Bohn D. Cardiovascular effects of mechanical ventilation. Arch Dis Child. 1999;80:475–80.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Shieh HHBE, Bousso A, Ventura AC, Troster EJ. Update of the pediatric hypotension graphic adjusted for gender and height percentiles: diastolic blood pressure for girls, 1 to 17 years old. Crit Care. 2013;17(Suppl 3):23.

    Google Scholar 

  • Sivarajan VB, Bohn D. Monitoring of standard hemodynamic parameters: heart rate, systemic blood pressure, atrial pressure, pulse oximetry, and end-tidal CO2. Pediatr Crit Care Med. 2011;12:S2–S11.

    PubMed  Google Scholar 

  • Sivarajan VB, Chrisant MR, Ittenbach RF, Clark BJ 3rd, Hanna BD, Paridon SM, Spray TL, Wernovsky G, Gaynor JW. Prevalence and risk factors for tricuspid valve regurgitation after pediatric heart transplantation. J Heart Lung Transplant. 2008;27:494–500.

    PubMed  Google Scholar 

  • Sivarajan VB, Best D, Brizard CP, Shekerdemian LS, d'Udekem Y, Butt W. Duration of resuscitation prior to rescue extracorporeal membrane oxygenation impacts outcome in children with heart disease. Intensive Care Med. 2011;37:853–60.

    PubMed  Google Scholar 

  • Sweet LR, Keech C, Klein NP, Marshall HS, Tagbo BN, Quine D, Kaur P, Tikhonov I, Nisar MI, Kochhar S, Muñoz FM. Respiratory distress in the neonate: case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine. 2017;35:6506–17.

    PubMed  PubMed Central  Google Scholar 

  • Thomson A. The role of negative pressure ventilation. Arch Dis Child. 1997;77:454–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Torp KD, Modi P, Simon LV. Pulse oximetry. In: StatPearls. Treasure Island, FL: StatPearls, Copyright © 2021, StatPearls Publishing LLC; 2021.

    Google Scholar 

  • Tregay J, Brown KL, Crowe S, Bull C, Knowles RL, Smith L, Wray J. Signs of deterioration in infants discharged home following congenital heart surgery in the first year of life: a qualitative study. Arch Dis Child. 2016;101:902.

    PubMed  Google Scholar 

  • van den Bosch OFC, Alvarez-Jimenez R, Stam MMH, den Boer FC, Loer SA. Variations in respiratory rate do not reflect changes in tidal volume or minute ventilation after major abdominal surgery. J Clin Monit Comput. 2021;35:787–96.

    PubMed  Google Scholar 

  • Zubrow AB, Hulman S, Kushner H, Falkner B. Determinants of blood pressure in infants admitted to neonatal intensive care units: a prospective multicenter study. Philadelphia neonatal blood pressure study group. J Perinatol. 1995;15:470–9.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Novick Cardiac Alliance, Memphis, TN, USA

    Stacey Marr

  2. Anesthesiology Research Center, Cardiac Anesthesiology Department, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Ali Dabbagh

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  1. Stacey Marr
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  2. Ali Dabbagh
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Correspondence to Ali Dabbagh .

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Editors and Affiliations

  1. Anesthesiology Research Center, Cardiac Anesthesiology Department, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Ali Dabbagh

  2. Department of Anesthesiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA

    Antonio Hernandez Conte

  3. UCLA Department of Anesthesiology and Perioperative Medicine, Divisions of Congenital Cardiac Anesthesiology Adult Cardiac Anesthesiology and Pediatric Anesthesiology, The University of California, David Geffen School of Medicine UCLA Health System, Los Angeles, CA, USA

    Lorraine N. Lubin

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Marr, S., Dabbagh, A. (2023). Perioperative Respiratory Monitoring in Congenital Heart Disease Patients. In: Dabbagh, A., Hernandez Conte, A., Lubin, L.N. (eds) Congenital Heart Disease in Pediatric and Adult Patients. Springer, Cham. https://doi.org/10.1007/978-3-031-10442-8_12

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  • DOI: https://doi.org/10.1007/978-3-031-10442-8_12

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