Persistent low cerebral blood flow velocity following profound hypothermic circulatory arrest in infants

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
B O'HareW Williams

Abstract

Acute neurological morbidity following repair of congenital heart disease (CHD) in infancy is well recognized, particularly with the modalities of hypothermic cardiopulmonary bypass (CPB) and profound hypothermic circulatory arrest (PHCA). Reduced O2 delivery (perfusion defect) during rewarming following PHCA has been shown in the operating room. This reduction in cerebral blood flow coincides with disordered cerebral metabolism and oxygen utilisation after PHCA. The objective of this study was to extend the period of investigation of cerebral blood flow velocity (CBFV) behaviour in infants following PHCA to determine if hypoperfusion persisted in the paediatric intensive care unit (PICU). Ten patients undergoing CHD surgery were divided, based on the pump modality employed, into either mild hypothermic CPB or profound hypothermic CPB with circulatory arrest. Following admission to the PICU, sequential recordings of the mean CBFV in the middle cerebral artery, anterior fontanelle pressure, haemodynamic variables, tympanic membrane temperature, haematocrit and PaCO2 were performed. The PHCA group had a consistently reduced CBFV compared with the control group (P < 0.05). The CBFV values at one, two and four hours were 60 +/- 11,...Continue Reading

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Citations

Dec 4, 1998·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·H L Pua, B Bissonnette
Oct 22, 2003·NeuroImage·Stephan G ErberichStefan Blüml
Apr 28, 2010·Artificial Organs·Xiaowei W Su, Akif Undar
Apr 12, 2001·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·A Y RazumovskyW A Baumgartner
Nov 20, 2013·Neurocritical Care·Georgios V VarsosMarek Czosnyka
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Feb 3, 2009·The Journal of Thoracic and Cardiovascular Surgery·Joseph D SchmokerJohn Kinne
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Apr 12, 2016·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·A KhalilJ S Carvalho
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