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

Adequate circulatory management in critical congenital heart diseases is vital in pediatrics because of poor prognosis. Understanding and managing factors such as contractility, load, cardiac morphology, and vascular resistance are vital in controlling cardiac output and maintaining balance between the systemic and pulmonary circulations. Particularly, in neonates, securing systemic blood flow through the regulation of pulmonary blood flow is an important issue, because there is a high risk of cardiogenic shock with increased pulmonary blood flow, resulting in general deterioration or death. Furthermore, not only cardiac care but also general care is needed to prevent several complications including non-cardiac complications. Detailed diagnosis, accurate understanding of the pathophysiology, and prediction of hemodynamics will lead to improved care of neonates with critical congenital heart disease.