Hemodynamic Response and Support After Deep Hypothermic Circulatory Arrest in Neonatal Patients Undergoing Surgical Repair of Congenital Heart Defects
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Authors
Howe, Michael
Issue Date
2003
Type
Thesis
Language
en_US
Keywords
Alternative Title
Abstract
Corrective surgery is a common and often necessary treatment for children born
with congenital heart defects. These are defects in the gross anatomy of the heart and
often affect the circulation of oxygenated blood through the body. As a result, surgery is
required at an extremely young and unstable age. Nearly all reparative surgeries for
congenital heart defects require opening the chest and using cardiopulmonary bypass.
The more severe defects require stopping the heart and dramatically cooling the body's
temperature, causing a state of complete circulatory arrest. The human response to
surgical stress has been well documented, but the effect of deep hypothermic circulatory
arrest (DHCA) on hemodynamic responses has yet to be described. Blood pressure, heart rate, and the amount of infused inotropic support, serum lactate, bicarbonate, and pH levels were recorded in infants less than three months of age over a 48-hour period
immediately after surgical repair of congenital heart defects. The patients who
underwent DHCA demonstrated significantly increased levels of serum lactate, and
required more inotropic support to maintain similar blood pressures and heart rates to
those patients not undergoing DHCA. Increased serum lactate is an indicator of
insufficient end-organ perfusion resulting from lower cardiac output as reflected by the
need for greater inotropic support in this group. Infants under 90 days of age undergoing
cardiac surgery and DHCA require greater inotropic support and have significantly
higher serum lactate levels than those who undergo cardiac surgery with
cardiopulmonary bypass only.
Description
v, 51 p.
Citation
Publisher
Kalamazoo College
License
U.S. copyright laws protect this material. Commercial use or distribution of this material is not permitted without prior written permission of the copyright holder.