Abstract
The incidence and prevalence of adolescent obesity and adolescent heart failure are increasing, and anesthesiologists increasingly will encounter patients with both conditions. A greater understanding of the physiologic challenges of adolescent heart failure as they relate to the perioperative stressors of anesthesia and bariatric surgery is necessary to successfully manage the perioperative risks faced by this growing subpopulation. Here, we present a representative case of a morbidly obese adolescent with heart failure who underwent a laparoscopic bariatric operation and review the limited available literature on perioperative management in this age group. Specifically, we review evidence and offer recommendations related to preoperative evaluation, venous thromboembolism prophylaxis, positioning, induction, airway management, monitoring, anesthetic maintenance, ventilator management, and adverse effects of the pneumoperitoneum, rhabdomyolysis, and postoperative care.
Original language | English (US) |
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Pages (from-to) | 476-482 |
Number of pages | 7 |
Journal | Paediatric anaesthesia |
Volume | 22 |
Issue number | 5 |
DOIs | |
State | Published - May 2012 |
Externally published | Yes |
Keywords
- adolescent obesity
- anesthetic implications
- anesthetic management
- bariatric surgery
- cardiomyopathy
- severe systolic heart failure
- sleeve gastrectomy
- teenager obesity
- weight-loss surgery
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Anesthesiology and Pain Medicine