日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

There is a close relationship between the pulmonary and systemic circulations (i.e., cardiopulmonary interaction) in patients with congenital heart diseases. Consequently, a deep understanding of respiratory and cardiac physiology is mandatory. Every patient has different hemodynamics even if they have the same diagnosis, thereby necessitating individualized therapy. Cardiac intensive care is the subspecialty of pediatric cardiology in which acutely ill patients receive care. A requirement of such intensive care is to maintain the balance between oxygen demand and oxygen consumption: to control demand, you can adjust body temperature and use sedatives, muscle relaxants, and artificial ventilation and to control oxygen supply, you can adjust inotropes, vasodilators, and ratio of pulmonary to systemic blood flow. These cardiorespiratory principles are essentially the same before and after corrective surgery. Additionally, neurological, infectious, and nutritional issues are relevant; therefore, cardiac intensivists must be familiar with both cardiac and non-cardiac issues.