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Chapter 15 - Cardiopulmonary Bypass for Pediatric Cardiac Surgery

Published online by Cambridge University Press:  24 October 2022

By
Joseph J Sistino  and
Timothy J Jones
Edited by
Florian Falter ,
Albert C. Perrino, Jr  and
Robert A. Baker
Florian Falter
Affiliation:
Royal Papworth Hospital, Cambridge
Albert C. Perrino, Jr
Affiliation:
Yale University Medical Center, Connecticut
Robert A. Baker
Affiliation:
Flinders Medical Centre, Adelaide
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Summary

Over the past 40 years, the trend has been to perform more complex, corrective and fewer palliative procedures on younger and smaller patients. Today, more than 50% of pediatric open-heart operations are performed in infants less than one year of age with more than 20% of all pediatric heart procedures performed during the first month of life. The outcomes following surgery for congenital heart disease have improved significantly in recent decades, which is in part due to advances made in our understanding and techniques of cardiopulmonary bypass (CPB).Pediatric perfusionists must have specialized knowledge related to pediatric physiology and congenital heart disease as well as the ability to utilize perfusion circuits adapted to a wide range of patient sizes. Pediatric perfusion cases can sometimes be very long due to the complexity of the cardiac repairs.

Keywords

Pediatric PerfusionPediatric Cardiopulmonary BypassPhysiology of Pediatric Cardiopulmonary BypassPediatric Myocardial ProtectionHemodilution
Type
Chapter
Information
Cardiopulmonary Bypass , pp. 150 - 155
Publisher: Cambridge University Press
Print publication year: 2022

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References

Suggested Further Reading

Harvey, B, Shann, KG, Fitzgerald, D et al. (2012). International pediatric perfusion practice: 2011 survey results. J Extra Corpor Technol, 44(4), 186–193.CrossRefGoogle ScholarPubMed
Sistino, JJ, Bonilha, HS. (2012). Improvements in survival and neurodevelopmental outcomes in surgical treatment of hypoplastic left heart syndrome: a meta-analytic review. J Extra Corpor Technol, 44(4), 216–223.CrossRefGoogle ScholarPubMed
Benziger, CP, Stout, K, Zaragoza-Macias, E et al. (2015). Projected growth of the adult congenital heart disease population in the United States to 2050: an integrative systems modeling approach. Popul Health Metr, 13, 29. doi:10.1186/s12963-015-0063-zCrossRefGoogle Scholar
Kirklin/Barratt-Boyes Cardiac Surgery 4th edition, by Kouchoukos, Nicholas T, Blackstone, Eugene H, Hanley, Frank L, and Kirklin, James K Chapter 2: Hypothermia, Circulatory Arrest, and Cardiopulmonary Bypass.Google Scholar
Allen, BS, Barth, MJ, Ilbawi, MN. (2001). Pediatric myocardial protection: an overview. Semin Thorac Cardiovasc Surg, 13(1), 56–72. doi:10.1053/stcs.2001.22738CrossRefGoogle ScholarPubMed
Sistino, JJ, Atz, AM, Ellis, C Jr. et al. (2015). Association between method of cerebral protection during neonatal aortic arch surgery and attention deficit/hyperactivity disorder. Ann Thorac Surg, 100(2), 663–670. doi:10.1016/j.athoracsur.2015.04.119Google Scholar
Wypij, D, Jonas, RA, Bellinger, DC et al. (2008). The effect of hematocrit during hypothermic cardiopulmonary bypass in infant heart surgery: results from the combined Boston hematocrit trials. J Thorac Cardiovasc Surg, 135(2), 355–360. doi:10.1016/j.jtcvs.2007.03.067Google Scholar
McCall, MM, Blackwel, MM, Smyre, JT et al. (2004). Fresh frozen plasma in the pediatric pump prime: a prospective, randomized trial. Ann Thorac Surg, 77(3), 983–987; discussion 987. doi:10.1016/j.athoracsur.2003.09.030CrossRefGoogle ScholarPubMed
Naik, SK, Knight, A, Elliott, M. (1991). A prospective randomized study of a modified technique of ultrafiltration during pediatric open-heart surgery. Circulation, 84(5 Suppl), III422–431.Google ScholarPubMed
McRobb, CM, Ing, RJ, Lawson, DS et al (2017). Retrospective analysis of eliminating modified ultrafiltration after pediatric cardiopulmonary bypass. Perfusion, 32(2), 97–109. doi:10.1177/0267659116669587CrossRefGoogle ScholarPubMed

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