Critical Matters Adult congenital disease in the ICU
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Feb 27, 2025 Dr. Cameron Dezfulian, a pediatric and adult critical care physician at Texas Children's Hospital, delves into the complexities of managing adults with congenital heart disease in intensive care. He discusses the unique challenges these patients face, including chronic conditions and the need for specialized care transitions. The conversation also highlights the intricacies of airway management in congenital anomalies and the critical role of multidisciplinary collaboration and effective communication for optimal patient outcomes.
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Growing Adult Congenital Population
- Adults with childhood-onset conditions are increasingly common in adult ICUs and will become your patients if they aren't already.
- Their chronic baselines differ fundamentally from typical adult comorbidities and change ICU goals and expectations.
Complex Lesions Drive ICU Risk
- Most simple congenital lesions have little long-term impact, but moderate-to-complex lesions drive excess adult morbidity and mortality.
- Expect tetralogy, transposition, Fontan physiology and Eisenmenger to pose unique ICU challenges.
Call Specialists Before Acting
- Anticipate complex arrhythmias and heart failure that do not follow usual algorithms.
- Consult adult congenital cardiology early and avoid applying standard structural-heart protocols blindly.
