title: Diaphragmatic palsy after cardiac surgical procedures in patients with congenital heart.
abstract: Paralysis of diaphragm on one or, exceptionally, both sides is a common cause of delayed recovery and excessive morbidity following pediatric cardiac surgery. The consequences of this complication after all forms of congenital heart surgery in newborns and young infants can be potentially serious. The impact of diaphragmatic palsy on the physiology after single ventricle palliations is particularly significant. It is necessary for all professionals taking care of children with heart disease to be familiar with the etiology, diagnosis, and management of this condition. Early recognition and prompt management of diaphragmatic palsy can potentially reduce the duration of mechanical ventilation and intensive care in those who develop this complication. This review summarizes the anatomy of the phrenic nerves, reasons behind the occurrence of diaphragmatic palsy, and suggests practical guidelines for management.
authors.affiliation: Cardiothoracic Centre and Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sachin
authors.initials: S
authors.lastname: Talwar
authors.forename: Sandeep
authors.initials: S
authors.lastname: Agarwala
authors.forename: Chander Mohan
authors.initials: CM
authors.lastname: Mittal
authors.forename: Shiv Kumar
authors.initials: SK
authors.lastname: Choudhary
authors.forename: Balram
authors.initials: B
authors.lastname: Airan
references.citation: Am J Surg. 1976 Aug;132(2):263-9
references.pmid: 952354
references.citation: Pediatr Crit Care Med. 2006 Sep;7(5):441-4
references.pmid: 16738495
references.citation: Eur J Cardiothorac Surg. 2005 Jan;27(1):53-7
references.pmid: 15621471
references.citation: Intensive Care Med. 2006 Aug;32(8):1222-6
references.pmid: 16741697
references.citation: Eur J Cardiothorac Surg. 2005 Apr;27(4):561-5
references.pmid: 15784351
references.citation: Eur J Cardiothorac Surg. 1990;4(9):487-90; discussion 490-1
references.pmid: 2223129
references.citation: J Thorac Cardiovasc Surg. 2001 Nov;122(5):856-62
references.pmid: 11689788
references.citation: Intensive Care Med. 2006 Aug;32(8):1227-33
references.pmid: 16741696
references.citation: An Esp Pediatr. 1996 Dec;45(6):591-6
references.pmid: 9133223
references.citation: J Appl Physiol. 1971 Oct;31(4):576-80
references.pmid: 5111005
references.citation: Pediatr Surg Int. 2006 Apr;22(4):341-6
references.pmid: 16518591
references.citation: Minerva Anestesiol. 1996 May;62(5):177-81
references.pmid: 9045095
references.citation: Eur J Cardiothorac Surg. 1998 Aug;14(2):179-84
references.pmid: 9755004
references.citation: J Thorac Cardiovasc Surg. 1999 Sep;118(3):510-7
references.pmid: 10469969
references.citation: Crit Care Med. 1979 Dec;7(12):563-6
references.pmid: 509971
references.citation: Cir Pediatr. 2001 Jan;14(1):21-4
references.pmid: 11339114
references.citation: J Thorac Cardiovasc Surg. 1987 Sep;94(3):383-8
references.pmid: 3626601
references.citation: Eur J Cardiothorac Surg. 1990;4(8):421-4
references.pmid: 2171593
references.citation: Ann Thorac Surg. 2003 Jul;76(1):234-6
references.pmid: 12842548
references.citation: J Thorac Cardiovasc Surg. 1978 Sep;76(3):297-304
references.pmid: 682661
references.citation: J Pediatr Surg. 1979 Dec;14(6):779-85
references.pmid: 399292
references.citation: Am Rev Respir Dis. 1992 Sep;146(3):797-9
references.pmid: 1519867
references.citation: Br Heart J. 1990 Jul;64(1):20-2
references.pmid: 2202361
references.citation: J Pediatr Surg. 1972 Dec;7(6):635-40
references.pmid: 4628963
references.citation: J Pediatr Surg. 1978 Jun;13(3):259-63
references.pmid: 671190
references.citation: Br Heart J. 1991 May;65(5):287-92
references.pmid: 2039675
references.citation: Q J Med. 1976 Jan;45(177):87-100
references.pmid: 1062815
references.citation: J Pediatr Surg. 1996 Sep;31(9):1265-7
references.pmid: 8887098