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Cardiopulmonary bypass—organ blood flow and metabolism in the pediatric patient

Published online by Cambridge University Press:  19 August 2008

W. Douglas Lazenby Jr  and
Karl H. Krieger
W. Douglas Lazenby Jr
Affiliation:
From the Department of Cardiothoracic Surgery, Cornell University Medical Center, New York
Karl H. Krieger*
Affiliation:
Washington University School of Medicine, Saint Louis and The Department of Cardiothoracic Surgery, Cornell University Medical Center, New York
*
Dr. Karl H. Krieger, 525 East 68th St., Room F2108, The New York Hospital-Cornell University Medical Center, New York, NY 10021, USA.
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Extract

Congenital heart disease occurs in roughly 0.7% of live-births. Approximately one-half of these defects are severe, requiring surgical correction or palliation. In a large percentage of such procedures in children, moderate or profound hypothermic cardiopulmonary bypass is employed. Because, nowadays, early correction of the defect rather than a palliative procedure is more frequently pursued, the surgeon, anesthesiologist, and perfusionist are called upon to manage younger and smaller children undergoing longer and more complex operations which necessitate longer times on bypass. Due to the particular underlying heart defect, the pathway of flow and viscosity of the blood are frequently different from those encountered in the adult with atherosclerotic coronary arterial or valvar heart disease. Thus, it is important for those caring for children undergoing cardiac surgery utilizing bypass to be well informed about its possible detrimental effects on the various organs. The purpose of this review will be to focus on the effects of bypass on flow to, and metabolism of, the organs and to highlight what is known with regard to these features in children rather than adults.

Keywords

Cardiopulmonary bypassorgan floworgan metabolismperfusion
Type
World Forum for Pediatric Cardiology Symposium on Cardiopulmonary Bypass (Part 1)
Information
Cardiology in the Young , Volume 3 , Issue 3 , July 1993 , pp. 232 - 243
Copyright
Copyright © Cambridge University Press 1993

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