medigraphic.com
ISSN 1561-3011 (Electronic)

2011, Number 4

<< Back Next >>

Rev Cubana Invest Bioméd 2011; 30 (4)

Hemodynamic assessment of extracorporeal circulation in normothermia and hypothermia in pediatric cardiovascular surgery

Marcano SL, Naranjo UA, Serrano RG, Romero SA

Language: Spanish
References: 20
Page: 450-456
PDF size: 111.85 Kb.


ABSTRACT

Hypothermia during the extracorporeal circulation is a common method in pediatric cardiovascular surgery. The normothermia was started by Lecompte in 1995. A randomized and prospective study was conducted in 100 children aged over 30 days to assess the hemodynamic changes in normothermia and hypothermia. In normothermia a temperature of 36 ºC, hematocrit higher than 30 % and a flow between 2,8 and 3,5 liter/min/m2 were used. In hypothermia, hematocrit between 24 and 30 % and a flow between 2,4 and 2,8 liters/min/m2. In normothermia extracorporeal circulation time and values of lactic acid were very lower, whereas the central venous saturation was higher at the end of extracorporeal one and at 6 hours in intensive therapy. In normothermia heart rate was higher at 6 hours and the rates of inotropics rates were lower at 24 hours. Normothermia protects the organs in a safe and effective way.


REFERENCES

  1. Bigelow WG, Callaghan JC, Hopps JA. General hypothermia for experimental intracardiac surgery. Am Surg. 1950;132:531.

  2. Sealy WC, Brown Jr IW, Youn Jr WG. A report on the use of both extracorporeal circulation and hypothermia for open heart surgery. Ann Surg. 1958;147:603-13.

  3. Pouard P, Mauriat PEF, Haydar A, Gioanni S, Laquay N, Vaccaroni L, et al. Normothermic cardiopulmonary bypass and myocardialcardioplegic protection for neonatal arterial switch operation. Eur J Cardiothorac Surg. 2006;30:695-9.

  4. Pigula FA, Siewers RD, Nemoto EM. Hypothermic cardiopulmonary bypass alters oxygen/glucose uptake in the pediatric brain. J Thorac Cardiovasc Surg. 2001;121(2):366-73.

  5. Lewis ME, Al-Khalidi AH, Townend JN, Coote J, Bonser RS. The effects of hypothermia on human left ventricular contractile function during cardiac function. J Am Coll Cardiol. 2002;39(1):102-8.

  6. Yamada S. Impaired endothelial responses in patients with deep hypothermic cardiopulmonary bypass. Kurume Med J. 2004;51(1):1-7.

  7. Birdi I, Caputo M, Underwood M, Bryan AJ, Angelini GD. The effects of cardiopulmonary bypass temperature on inflammatory response following cardiopulmonary bypass. Eur J Cardiothorac Surg. 1999;16:540-5.

  8. Durandy Y, Hulin S, Lecompte Y. Normothermic cardiopulmonary bypass in pediatric surgery. J Thorac Cardiovasc Surg. 2002;123:194.

  9. Jenkins KJ, Gauvreau K, Newburger JW, Spray TL, Moller JH, Iezzoni LI. Consensus-based method for risk adjustment for surgery for congenital heart disease. J Thorac Cardiovasc Surg. 2002;123:110-8.

  10. Gaies MG, Ohye MPH, Gurney JG, Yen AH, Napoli ML, Gajarski RJ. Vasoactive inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass. Pediatr Crit Care Med. 2010;11:234-38.

  11. Salerno TA. Warm heart surgery: Reflections on the history of its development. J Card Surg. 2007;22:257-9.

  12. Durandy Y, Hulin S. Discontinuous warm cardioplegia in pediatric cardiac surgery: preliminary results. Arch Mal Coeur Vaiss. 2006;99(2):103-7.

  13. Durandy Y, Younes M, Mahut B. Pediatric Warm Open Heart Surgery and Prolonged Cross-Clamp Time. Ann Thorac Surg. 2008;86:1941-7.

  14. Belli E, Roussin R, Ly M, Le Bret E, Basaran M, Serraf A. Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery Associated With Severe Left Ventricular Dysfunction: Results in Normothermia. Ann Thorac Surg. 2010;90(3): 856-60.

  15. Cassano V, Milella L. Warm surgery, our experience. Eur J Cardiothorac Surg. 2007;31:754-5.

  16. Corno AF. What are the best temperature, flow, and hematocrit levels for Pediatric cardiopulmonary bypass? J Thorac Cardiovasc Surg. 2002;124:856-7.

  17. Caputo M, Bays S, Rogers CA, Pawade A, Parry AJ, Suleiman S. Randomizedcomparison between normothermic and hypothermic cardiopulmonary bypass in pediatric open-heart surgery. Ann Thorac Surg. 2005;80:982-8.

  18. Barrial J, Facenda A, Bravo Luis, Pérez A. Hiperlactatemia durante la cirugía cardiaca pediátrica con circulación extracorpórea. Rev Cubana Anestesiol Reanim. 2009;8(2):34-40.

  19. Durandy Y. Warm Pediatric Cardiac Surgery: European Experience. Asian Cardiovasc Thorac Ann. 2010;18:386-95.

  20. Durandy Y. Pediatric myocardial protection. Curr Opin Cardiol. 2008;23:85-90.




2020     |     www.medigraphic.com