NORMOTHERMIA FOR PEDIATRIC AND CONGENITAL HEART SURGERY: AN EXPANDED HORIZON
Cardiopulmonary bypass (CPB) in pediatric cardiac surgery is generally performed with hypothermia, flow reduction and hemodilution. From 10/2013 to 12/2014 55 patients, median age 6 years (range 2 months to 52 years), median weight 18.5kg (range 3.2 to 57 kg), underwent surgery with normothermic hig...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2015-04-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fped.2015.00023/full |
| _version_ | 1828736635643101184 |
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| author | Ahmad Mahir eShamsuddin Ahmad eMohd Nikman Saedah eAli Mohd Rizal eMohd Zain Abdul Rahim eWong Antonio Francesco Corno Antonio Francesco Corno |
| author_facet | Ahmad Mahir eShamsuddin Ahmad eMohd Nikman Saedah eAli Mohd Rizal eMohd Zain Abdul Rahim eWong Antonio Francesco Corno Antonio Francesco Corno |
| author_sort | Ahmad Mahir eShamsuddin |
| collection | DOAJ |
| description | Cardiopulmonary bypass (CPB) in pediatric cardiac surgery is generally performed with hypothermia, flow reduction and hemodilution. From 10/2013 to 12/2014 55 patients, median age 6 years (range 2 months to 52 years), median weight 18.5kg (range 3.2 to 57 kg), underwent surgery with normothermic high flow CPB in a new unit.There were no early or late deaths. Fifty patients (90.9%) were extubated within 3 hrs, 3 (5.5%) within 24 hrs and 2 (3.6%) within 48 hrs. Twentyfour patients (43.6%) didn’t require inotropic support, 31 (56.4%) received dopamine or dobutamine: 21 ≤5 mcg/kg/min, 8 5-10 mcg/kg/min, and 2 >10 mcg/kg/min. Two patients (6.5%) required noradrenaline 0.05-0.1 mcg/kg/min.On arrival to ICU and after 3 and 6 hrs and 8:00 am the next morning, mean lactate levels were 1.9±09, 2.0±1.2, 1.6±0.8 and 1.4±0.7 mmol/L (0.6-5.2 mmol/L) respectively. From arrival to ICU to 8:00 am the next morning mean urine output was 3.8±1.5 mL/kg/hr (0.7-7.6 mL/kg/hr), and mean chest drainage was 0.6±0.5 mL/kg/hr (0.1-2.3 mL/kg/hr). Mean ICU and hospital stay were 2.7±1.4 days (2-8 days) and 7.2±2.2 days (4-15 days) respectively. In conclusion, normothermic high flow CPB allows pediatric and congenital heart surgery with favorable outcomes even in a new unit. The immediate post-operative period is characterized by low requirement for inotropic and respiratory support, low lactate production, adequate urine output, minimal drainage from the chest drains, shorter ICU and hospital stay. |
| first_indexed | 2024-04-12T23:29:00Z |
| format | Article |
| id | doaj.art-1bb08a5c6ca9472d81636bda1ce9171e |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-12T23:29:00Z |
| publishDate | 2015-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-1bb08a5c6ca9472d81636bda1ce9171e2022-12-22T03:12:19ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602015-04-01310.3389/fped.2015.00023138367NORMOTHERMIA FOR PEDIATRIC AND CONGENITAL HEART SURGERY: AN EXPANDED HORIZONAhmad Mahir eShamsuddin0Ahmad eMohd Nikman1Saedah eAli2Mohd Rizal eMohd Zain3Abdul Rahim eWong4Antonio Francesco Corno5Antonio Francesco Corno6School of Medical Sciences, Health CampusUniversiti Sains MalaysiaUniversiti Sains MalaysiaUniversiti Sains MalaysiaHospital Raja Perempuan Zainab IISchool of Medical Sciences, Health CampusUniversiti Sains MalaysiaCardiopulmonary bypass (CPB) in pediatric cardiac surgery is generally performed with hypothermia, flow reduction and hemodilution. From 10/2013 to 12/2014 55 patients, median age 6 years (range 2 months to 52 years), median weight 18.5kg (range 3.2 to 57 kg), underwent surgery with normothermic high flow CPB in a new unit.There were no early or late deaths. Fifty patients (90.9%) were extubated within 3 hrs, 3 (5.5%) within 24 hrs and 2 (3.6%) within 48 hrs. Twentyfour patients (43.6%) didn’t require inotropic support, 31 (56.4%) received dopamine or dobutamine: 21 ≤5 mcg/kg/min, 8 5-10 mcg/kg/min, and 2 >10 mcg/kg/min. Two patients (6.5%) required noradrenaline 0.05-0.1 mcg/kg/min.On arrival to ICU and after 3 and 6 hrs and 8:00 am the next morning, mean lactate levels were 1.9±09, 2.0±1.2, 1.6±0.8 and 1.4±0.7 mmol/L (0.6-5.2 mmol/L) respectively. From arrival to ICU to 8:00 am the next morning mean urine output was 3.8±1.5 mL/kg/hr (0.7-7.6 mL/kg/hr), and mean chest drainage was 0.6±0.5 mL/kg/hr (0.1-2.3 mL/kg/hr). Mean ICU and hospital stay were 2.7±1.4 days (2-8 days) and 7.2±2.2 days (4-15 days) respectively. In conclusion, normothermic high flow CPB allows pediatric and congenital heart surgery with favorable outcomes even in a new unit. The immediate post-operative period is characterized by low requirement for inotropic and respiratory support, low lactate production, adequate urine output, minimal drainage from the chest drains, shorter ICU and hospital stay.http://journal.frontiersin.org/Journal/10.3389/fped.2015.00023/fullCardiopulmonary BypassHemodilutionsurgical outcomescongenital heart defectsNormothermiaHigh flow |
| spellingShingle | Ahmad Mahir eShamsuddin Ahmad eMohd Nikman Saedah eAli Mohd Rizal eMohd Zain Abdul Rahim eWong Antonio Francesco Corno Antonio Francesco Corno NORMOTHERMIA FOR PEDIATRIC AND CONGENITAL HEART SURGERY: AN EXPANDED HORIZON Frontiers in Pediatrics Cardiopulmonary Bypass Hemodilution surgical outcomes congenital heart defects Normothermia High flow |
| title | NORMOTHERMIA FOR PEDIATRIC AND CONGENITAL HEART SURGERY: AN EXPANDED HORIZON |
| title_full | NORMOTHERMIA FOR PEDIATRIC AND CONGENITAL HEART SURGERY: AN EXPANDED HORIZON |
| title_fullStr | NORMOTHERMIA FOR PEDIATRIC AND CONGENITAL HEART SURGERY: AN EXPANDED HORIZON |
| title_full_unstemmed | NORMOTHERMIA FOR PEDIATRIC AND CONGENITAL HEART SURGERY: AN EXPANDED HORIZON |
| title_short | NORMOTHERMIA FOR PEDIATRIC AND CONGENITAL HEART SURGERY: AN EXPANDED HORIZON |
| title_sort | normothermia for pediatric and congenital heart surgery an expanded horizon |
| topic | Cardiopulmonary Bypass Hemodilution surgical outcomes congenital heart defects Normothermia High flow |
| url | http://journal.frontiersin.org/Journal/10.3389/fped.2015.00023/full |
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