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Regional low-flow perfusion provides somatic circulatory support during neonatal aortic arch surgery.
Pigula, F A; Gandhi, S K; Siewers, R D; Davis, P J; Webber, S A; Nemoto, E M.
Afiliación
  • Pigula FA; Division of Pediatric Cardiothoracic Surgery, Children's Hospital of Pittsburgh, University of Pittsburgh, Pennsylvania 15213, USA. pigulaf@heart.chp.edu
Ann Thorac Surg ; 72(2): 401-6; discussion 406-7, 2001 Aug.
Article en En | MEDLINE | ID: mdl-11515874
BACKGROUND: Regional low-flow perfusion has been shown to provide cerebral circulatory support during neonatal aortic arch operations. However, its ability to provide somatic circulatory support remains unknown. METHODS: Fifteen neonates undergoing arch reconstruction with regional perfusion were studied. Three techniques were used to assess somatic perfusion: abdominal aortic blood pressure, quadriceps blood flow (near-infrared spectroscopy), and gastric tonometry. RESULTS: Twelve patients required operation for hypoplastic left heart syndrome, and 3 required arch reconstruction with a biventricular repair. There was one death (7%). Abdominal aortic blood pressure was higher (12+/-3 mm Hg versus 0+/-0 mm Hg), and quadriceps blood volumes (5+/-24 versus -17+/-26) and oxygen saturations (57+/-25 versus 33+/-12) were greater during regional perfusion than during deep hypothermic circulatory arrest (p < 0.05). During rewarming, the arterial-gastric mucosal carbon dioxide tension difference was lower after circulatory arrest than after regional perfusion (-3.3+/-0.3 mm Hg versus 7.8+/-7.6 mm Hg, p < 0.05). CONCLUSIONS: Regional low-flow perfusion provides somatic circulatory support during neonatal arch surgical procedures. Support of the subdiaphragmatic viscera should improve the ability of neonates to survive the postoperative period.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aorta Torácica / Coartación Aórtica / Estómago / Puente Cardiopulmonar / Músculo Esquelético / Síndrome del Corazón Izquierdo Hipoplásico Límite: Female / Humans / Male / Newborn Idioma: En Revista: Ann Thorac Surg Año: 2001 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aorta Torácica / Coartación Aórtica / Estómago / Puente Cardiopulmonar / Músculo Esquelético / Síndrome del Corazón Izquierdo Hipoplásico Límite: Female / Humans / Male / Newborn Idioma: En Revista: Ann Thorac Surg Año: 2001 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos