Document Detail


Influence of external cardiac pacing on cerebral oxygenation measured by near-infrared spectroscopy in children after cardiac surgery.
MedLine Citation:
PMID:  20412455     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The brain of children in the early period after repair of congenital heart defects with cardiopulmonary bypass (CPB) may be more vulnerable to hemodynamic changes because of impaired cerebral autoregulation. During postoperative testing of the external temporary safety pacer, we performed desynchronizing ventricular pacing (VVI) while monitoring cerebral oxygenation using near-infrared spectroscopy (NIRS). METHODS: We prospectively investigated 11 children (6 girls, 5 boys). Mean age was 6.1 months (+/-3.8 months) and mean weight: 5.3 kg (+/-1.5 kg). We performed measurements at four study steps: baseline I, VVI pacing, baseline II and atrial pacing (AOO) to exclude effects of higher heart rate. We continuously measured the effects on hemodynamic and respiratory parameters as well as on cerebral tissue oxygenation index (TOI). Hemoglobin difference (HbD) was calculated as a parameter for cerebral blood flow (CBF). RESULTS: Ventricular pacing leads to a significant decrease in arterial blood pressure and central venous saturation accompanied by an immediate and significant decrease in TOI (63.3% +/- 7.6% to 61.5% +/- 8.4% [P < 0.05]) and HbD (0.51 +/- 1.8 micromol.l(-1) to -2.9 +/- 4.7 micromol.l(-1) [P < 0.05]). CONCLUSION: Cardiac desynchronization after CPB seems to reduce CBF and cerebral oxygenation in children.
Authors:
Thilo Fleck; Stefan Schubert; Matthias Redlin; Brigitte Stiller; Peter Ewert; Felix Berger; Nicole Nagdyman
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Publication Detail:
Type:  Journal Article     Date:  2010-04-12
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  20     ISSN:  1460-9592     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-10-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  553-8     Citation Subset:  IM    
Affiliation:
Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, Berlin, Germany. thilofleck@web.de
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, General
Blood Gas Analysis
Brain Chemistry / physiology*
Cardiac Pacing, Artificial*
Cardiac Surgical Procedures*
Cerebrovascular Circulation
Female
Hemodynamics / drug effects
Hemoglobins / metabolism
Humans
Infant
Male
Oxygen / blood
Oxygen Consumption / physiology*
Prospective Studies
Spectroscopy, Near-Infrared
Chemical
Reg. No./Substance:
0/Hemoglobins; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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