# Critical Care of the Adult With Congenital Heart Disease

## TL;DR

This paper reviews the growing need for specialized critical care for adults with congenital heart disease due to their unique medical challenges and increasing complexity.

## Contribution

The paper identifies key management considerations and highlights the need for future research and training in critical care for adults with congenital heart disease.

## Key findings

- The population of adults with CHD requiring critical care is growing in volume and complexity.
- Adults with CHD have unique hemodynamic profiles with limited evidence to guide ICU care.
- Future research and workforce development are essential to improve outcomes for critically ill adults with CHD.

## Abstract

Advances in the treatment of congenital heart disease (CHD) have led to dramatic improvements in survival for individuals with CHD. While adults with CHD represent a small percentage of admissions to the intensive care unit (ICU), the critical care needs of this population will grow as this population ages and develops increasingly complex cardiac and noncardiac conditions. Adults with CHD require special care in the ICU because of both their unique cardiovascular conditions and the multi-organ dysfunction that often accompanies their cardiac pathophysiology. This review aims to summarize the current epidemiology of critical care for adults with CHD, describe key physiologic and management considerations in caring for adults with highly complex CHD (eg, Fontan circulation, systemic right ventricle, and Eisenmenger syndrome), identify cardiac and noncardiac risk factors for adverse outcomes following admission to the ICU, and define key research and educational priorities for the future care of this vulnerable population.

•The population of adults with CHD requiring critical care is growing in total volume and complexity.•Adults with CHD have unique hemodynamic and physiologic profiles with sparse evidence to guide critical care.•Future research, training, and workforce development are needed to improve the care of critically ill adults with CHD.

The population of adults with CHD requiring critical care is growing in total volume and complexity.

Adults with CHD have unique hemodynamic and physiologic profiles with sparse evidence to guide critical care.

Future research, training, and workforce development are needed to improve the care of critically ill adults with CHD.