Inpatient Transition From Intravenous to Inhaled Treprostinil in a Pediatric Patient.

We report a case of a 7-year old male with idiopathic pulmonary arterial hypertension, successfully transitioned from an intravenous infusion to inhaled treprostinil during inpatient admission, after his intentional removal of multiple central venous catheters. He had no clinical, echocardiographic, or serum biomarker evidence of loss of control of pulmonary arterial hypertension during the 4-day transition. The patient was discharged home without complications, and 3 weeks after discharge the patient's pulmonary hypertension remained well controlled per clinical and echocardiographic evidence, including a significantly improved 6-minute walk distance test.

Update on complications of pediatric cardiac surgery.

Management of the pediatric patient after congenital heart disease surgery requires a multidisciplinary team approach. All members of the team must understand the risk factors, pathophysiology, and management of common postoperative problems such as low cardiac output, pulmonary hypertension, and chylothorax to assure early recognition and intervention.