**Author details**

**12.4. Peculiar problems**

152 Heart Transplantation

min supplementation.

BIS bispectral index

CI cardiac index CO cardiac output

**Abbreviations**

In the postoperative setting, the main problems for pediatric patients are comorbidities related

• Cyanotic congenital heart disease: patients with long standing hypoxemia often develop severe alteration of whole blood viscosity and alteration of coagulation profiles with high

• Plastic bronchitis: it is a rare complication of univentricular physiology characterized by the formation of exudative airway casts that can occlude airways and cause respiratory failure. The etiology is still not well identified, but it seems to relate to an increased central

• Protein losing enteropathy (PLE): it is defined as a possible complication of the univentricular circulation. It can arise after the Fontan operation (5–15% of the patients) [33]. It is characterized by the abnormal loss of proteins into the enteral lumen, which results in hypoproteinemia and hypoalbuminemia. This leads to an increase of lymphatic drainage and a dilation of intestinal lymphatic system with an impaired fat absorption resulting in steatorrhea. Moreover, the hypoproteinemia may result also in ascites, peripheral edema, and pleural/pericardial effusion. Therapy consists of diuretics, corticosteroids, and albu-

to chronic decompensation and univentricular physiology.

venous pressure or lymphatic drainage alterations [32].

COPD chronic obstructive pulmonary disease

CVVH central venovenous hemofiltration

HIT heparin-induced thrombocytopenia

ICD implantable cardioverter defibrillator

IABP intra-aortic balloon pump

ECMO extracorporeal membranous oxygenation

DLCO carbon monoxide lung diffusion

CPB cardiopulmonary bypass CVC central venous catheter CVP central venous pressure

risk of postoperative bleeding [31].

Massimo Baiocchi\*, Maria Benedetto, Marta Agulli and Guido Frascaroli

\*Address all correspondence to: massimo.baiocchi@aosp.bo.it

Anaesthesiology and Intensive Care Unit, Cardiothoracic and vascular Department, Policlinico S. Orsola University Hospital, Bologna, Italy
