Anesthetic Management for the Pediatric Patient Undergoing Deep Hypothermic Circulatory Arrest

Author:

Schlunt Michelle L.1,Brauer Stanley D.2

Affiliation:

1. Loma Linda University Medical Center, 11234 Anderson Street, Loma Linda, CA 92354;

2. Loma Linda University Medical Center, Loma Linda, California.

Abstract

Early definitive repair of complex congenital heart defects is now advocated. For the completion of many of these repairs, the use of deep hypothermic circulatory arrest (DHCA) is an absolute necessity. Unfortunately, there is undeniable neurologic morbidity, as well as other complications associated with DHCA. Anesthesiologists can aid in minimizing these unfortunate complications with the appropriate anesthetic management. Areas of current controversy in managing pediatric patients undergoing DHCA, which will be covered in this article, include cardiopulmonary bypass strategies (low-flow cardiopulmonary bypass versus DHCA), arterial blood gas management, hemodilution effects, glucose management, and the use of steroids, barbiturates, and antifibrinolytics. Every institution varies in their techniques, and there is always some new insight to be gained from discussion of these differences. At this time, anesthesiologists and surgeons alike are striving to gain further understanding of what truly occurs with the use of DHCA and in turn apply this clinically to provide better care for all pediatric patients undergoing this unique management.

Publisher

SAGE Publications

Subject

Anesthesiology and Pain Medicine,Cardiology and Cardiovascular Medicine

Cited by 8 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Total circulatory arrest as a support modality in congenital heart surgery: review and current evidence;Indian Journal of Thoracic and Cardiovascular Surgery;2020-03-09

2. Kongenitale Herzfehler;Anästhesie und Intensivmedizin in der Herz-, Thorax- und Gefäßchirurgie;2016-11-01

3. Cardiovascular Surgery and Cardiologic Procedures;Manual of Pediatric Anesthesia;2016

4. Serum UCH-L1 as a Novel Biomarker to Predict Neuronal Apoptosis Following Deep Hypothermic Circulatory Arrest;International Journal of Medical Sciences;2015

5. Kongenitale Herzfehler: Anästhesie und Intensivbehandlung;Anästhesie und Intensivmedizin in Herz-, Thorax- und Gefäßchirurgie;2012

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