Mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass and short-term outcomes in children with congenital heart defects

Background: Among the known risk factors for children undergoing surgery for congenital heart defect (CHD), temperature and blood flow during cardiopulmonary bypass (CPB), are two risk factors, which may be altered to improve outcomes. Moderate - to - deep hypothermia (MDH), traditionally used, has...

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Main Authors: Utpal S Bhalala, Pranali Awadhare, Malarvizhi Thangavelu, Richard Owens, Maria Zamora, Daniel Nento, Elumalai Appachi, Muhammad Ali Mumtaz
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2021-01-01
Series:Journal of Pediatric Critical Care
Subjects:
Online Access:http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2021;volume=8;issue=1;spage=13;epage=19;aulast=Bhalala
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spelling doaj-e23325c545c04b3aa0a0db951a9e8ee92021-02-03T07:03:28ZengWolters Kluwer Medknow PublicationsJournal of Pediatric Critical Care2349-65922455-70992021-01-0181131910.4103/JPCC.JPCC_125_20Mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass and short-term outcomes in children with congenital heart defectsUtpal S BhalalaPranali AwadhareMalarvizhi ThangaveluRichard OwensMaria ZamoraDaniel NentoElumalai AppachiMuhammad Ali MumtazBackground: Among the known risk factors for children undergoing surgery for congenital heart defect (CHD), temperature and blood flow during cardiopulmonary bypass (CPB), are two risk factors, which may be altered to improve outcomes. Moderate - to - deep hypothermia (MDH), traditionally used, has been associated with short/long-term neurologic sequelae, so there is a move towards mild hypothermia (MH) with selective antegrade cerebral perfusion (SACP). Aims and Objectives: To assess feasibility of mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass as a cardiopulmonary bypass strategy in neonates and infants undergoing surgery for congenital heart defect. Materials and Methods: We conducted a retrospective chart review of neonates and infants who underwent SACP on CPB during CHD surgery at our tertiary care children's hospital between January 2014 and February 2017. We categorized all the patients into 2 groups - MH + SACP or MDH + SACP. We gathered data on preoperative, intra-operative and post-operative parameters. We analyzed comparative data using student t-test and chi-squared test with a significant p-value < 0.05. Results: There were 6 in the MH + SACP group and 7 in the MDH + SACP group, who underwent SACP on CPB during study period at our children's hospital. All the neonates and infants in the MH + SACP group survived at the hospital discharge with favorable neurologic outcomes. There was no statistically significant difference between the two groups for end organ dysfunction, ventilator days, hospital days, ICU and hospital mortality and PCPC/POPC at hospital discharge. Conclusions: Mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass is a feasible cardiopulmonary bypass strategy in neonates and infants undergoing surgery for congenital heart defect.http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2021;volume=8;issue=1;spage=13;epage=19;aulast=Bhalalacardiopulmonary bypasscongenital heart defectshypothermiaselective antegrade cerebral perfusion
collection DOAJ
language English
format Article
sources DOAJ
author Utpal S Bhalala
Pranali Awadhare
Malarvizhi Thangavelu
Richard Owens
Maria Zamora
Daniel Nento
Elumalai Appachi
Muhammad Ali Mumtaz
spellingShingle Utpal S Bhalala
Pranali Awadhare
Malarvizhi Thangavelu
Richard Owens
Maria Zamora
Daniel Nento
Elumalai Appachi
Muhammad Ali Mumtaz
Mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass and short-term outcomes in children with congenital heart defects
Journal of Pediatric Critical Care
cardiopulmonary bypass
congenital heart defects
hypothermia
selective antegrade cerebral perfusion
author_facet Utpal S Bhalala
Pranali Awadhare
Malarvizhi Thangavelu
Richard Owens
Maria Zamora
Daniel Nento
Elumalai Appachi
Muhammad Ali Mumtaz
author_sort Utpal S Bhalala
title Mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass and short-term outcomes in children with congenital heart defects
title_short Mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass and short-term outcomes in children with congenital heart defects
title_full Mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass and short-term outcomes in children with congenital heart defects
title_fullStr Mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass and short-term outcomes in children with congenital heart defects
title_full_unstemmed Mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass and short-term outcomes in children with congenital heart defects
title_sort mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass and short-term outcomes in children with congenital heart defects
publisher Wolters Kluwer Medknow Publications
series Journal of Pediatric Critical Care
issn 2349-6592
2455-7099
publishDate 2021-01-01
description Background: Among the known risk factors for children undergoing surgery for congenital heart defect (CHD), temperature and blood flow during cardiopulmonary bypass (CPB), are two risk factors, which may be altered to improve outcomes. Moderate - to - deep hypothermia (MDH), traditionally used, has been associated with short/long-term neurologic sequelae, so there is a move towards mild hypothermia (MH) with selective antegrade cerebral perfusion (SACP). Aims and Objectives: To assess feasibility of mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass as a cardiopulmonary bypass strategy in neonates and infants undergoing surgery for congenital heart defect. Materials and Methods: We conducted a retrospective chart review of neonates and infants who underwent SACP on CPB during CHD surgery at our tertiary care children's hospital between January 2014 and February 2017. We categorized all the patients into 2 groups - MH + SACP or MDH + SACP. We gathered data on preoperative, intra-operative and post-operative parameters. We analyzed comparative data using student t-test and chi-squared test with a significant p-value < 0.05. Results: There were 6 in the MH + SACP group and 7 in the MDH + SACP group, who underwent SACP on CPB during study period at our children's hospital. All the neonates and infants in the MH + SACP group survived at the hospital discharge with favorable neurologic outcomes. There was no statistically significant difference between the two groups for end organ dysfunction, ventilator days, hospital days, ICU and hospital mortality and PCPC/POPC at hospital discharge. Conclusions: Mild hypothermia with selective antegrade cerebral perfusion during cardiopulmonary bypass is a feasible cardiopulmonary bypass strategy in neonates and infants undergoing surgery for congenital heart defect.
topic cardiopulmonary bypass
congenital heart defects
hypothermia
selective antegrade cerebral perfusion
url http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2021;volume=8;issue=1;spage=13;epage=19;aulast=Bhalala
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