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Indian Journal of Anesthesia and Analgesia 12(2):p 121-124, April -June 2025. | DOI: 10.21088/ijaa.2349.8471.12225.6
Case Report
Anaesthetic Management of Paediatrics Patient with Dilated Cardiomyopathy Posted for Wound Debridement
Karthik C., Mr. Vishnuvardhan, Ms. Anushri
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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Anesthesia and Analgesia 12(2):p 121-124, April -June 2025. | DOI: 10.21088/ijaa.2349.8471.12225.6
How Cite This Article:
Karthik C, Vishnuvardhan, Anushri. Anaesthetic management of paediatrics patient with dilated cardiomyopathy posted for wound debridement. Ind J Anesth Analg. 2025;12(2):121-124.Timeline
Received : January 25, 2025
Accepted : March 06, 2025
Published : June 23, 2025
Abstract
Introduction: Dilated Cardiomyopathy is a syndrome characterized by cardiac enlargement and impaired systolic function of one or both ventricles. A large number of cases are idiopathic. The known causes are ischemic, valve dysfunction and post viral infection. DCM can also be found in association with sickle cell disease, muscular dystrophy, excess alcohol, hypothyroidism and some chemotherapy agents or during peripartum period. Patients with dilated cardiomyopathy are regarded to be of high risk for perioperative complications, necessitating diligent anaesthetic management. Case report: A 2 year old girl child diagnosed with the cellulitis of left upper limb And left foot, with query of osteomyelitis of left elbow joint posted for incision and drainage and wound debridement. Child presented with a history of dilated cardiomyopathy diagnosed at the age of 6 months and was put on medication. 2D echocardiography showed dilated left ventricle with global hypokinesia of left ventricle with sever left ventricular systolic dysfunction, with ejection fraction of 20 percent. On examination wound to have severe anaemia with Hb of 5g%. Through pre-operative cardiovascular stabilisation done by consultation of cardiologist opinion in view of DCM and Paediatrician in view of anaemia. Standard monitoring ensured perioperatively with keen monitoring over cardiovascular status. On the day of surgery, patient Blood Pressure (BP) was 96/60 mm Hg, Heart Rate (HR) was 130/min and oxygen saturation (SaO2) was 100% on room air. Other parameters monitored were ECG, end tidal carbon dioxide and oxygen saturation. anaesthesia was induced slowly with iv ketamine 3.5mg, and iv succinylcholine 7 mg. LMA of size 2 was used. Anaesthesia was maintained with O2/N2O, servoflurane (mac 3.5-1). Surgery was completed in 60 minutes Intraoperatively total IV fluids 60 ml given. At the end of surgery LMA removed and patient was kept in Paediatrics icu for one day for observation Conclusion: As the patient posted for wound debridement with known history of DCM. Hemodynamic management and support was extremely useful to these patients. Due to short procedure, LMA was selected to avoid the post intubation responses. And maintained minimal IV fluids In this case, the anaesthetic management was handled successfully without any consequences.
References
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- 2. Mallavarapu A, Taksande A. Dilated Cardiomyopathy in Children: Early Detection and Treatment. Cureus. 2022; 4: 14(11).
- 3. “Maekawa T. Anesthetic management of patients with dilated cardiomyopathy undergoing non-cardiac surgery. Masui. 2014; 63(1): 22-30.
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Author Contributions
All authors contributed significantly to the work and approve its publication.
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This article does not involve any human or animal subjects, and therefore does not require ethics approval.
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Cite this article
Karthik C, Vishnuvardhan, Anushri. Anaesthetic management of paediatrics patient with dilated cardiomyopathy posted for wound debridement. Ind J Anesth Analg. 2025;12(2):121-124.
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| January 25, 2025 | March 06, 2025 | June 23, 2025 |
DOI: 10.21088/ijaa.2349.8471.12225.6
Keywords
Anaesthetic managementDCMWound debridementSearch for Similar Articles
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Timeline
| Received | January 25, 2025 |
| Accepted | March 06, 2025 |
| Published | June 23, 2025 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
