Abstract
50 days old, 4.5kg male patient was admitted at department of pediatrics due to congenital heart disease with congestive heart failure. The echocardiographic finding was perimembranous type ventricular septal defect. The patient underwent open heart surgery for patch closure of VSD. Immediately postoperatively, junctional ectopic tachycardia developed and the patient was in hemodynamically unstable state with decreased urine output. We used inotropics, digitalis and diuretics, however these treatments were not effective in recovering the unstable state. Therefore, we tried a mild hypothermic treatment(34℃). During the POD #2, mild hypothermia method was repeated four times. The junctional ectopic tachycardia was converted to normal sinus rhythm, hemodynamic state was stable, and urine output was increased. The patient was discharged at POD #8.
환아는 생후 50일된 체중 4.5kg의 남아로 선천성 심장질환 및 울혈성 심부전증으로 본원에 내원하여 시행한 심초음파상 막주위형 심실중격결손으로 진단되어 수술하였다. 수술후 중환자실에서 치료하던 중 방실접합부 이소성 빈맥이 발생하면서 혈역학적으로 불안정한 상태가 되었고 요량이 감소하여 강심제 및 이뇨제등의 약물 치료를 하였으나 호전되지 않아서 경도의 저체온(34℃)치료를 병행하였다. 술후 2일 동안 4차례의 저체온 치료로 방실접합부 이소성 빈맥은 정상 동율동으로 전환 되었고 혈역학적으로도 안정되었으며 요량도 증가 되어 수술후 8일에 정상 퇴원하였다.