Document Detail


Regional low-flow perfusion provides cerebral circulatory support during neonatal aortic arch reconstruction.
MedLine Citation:
PMID:  10649209     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Because of concerns regarding the effects of deep hypothermia and circulatory arrest on the neonatal brain, we have developed a technique of regional low-flow perfusion that provides cerebral circulatory support during neonatal aortic arch reconstruction. METHODS: We studied the effects of regional low-flow perfusion on cerebral oxygen saturation and blood volume as measured by near-infrared spectroscopy in 6 neonates who underwent aortic arch reconstruction and compared these effects with 6 children who underwent cardiac repair with deep hypothermia and circulatory arrest. RESULTS: All the children survived with no observed neurologic sequelae. Near-infrared spectroscopy documented significant decreases in both cerebral blood volume and oxygen saturations in children who underwent repair with deep hypothermia and circulatory arrest as compared with children with regional low-flow perfusion. Reacquisition of baseline cerebral blood volume and cerebral oxygen saturations were accomplished with a regional low-flow perfusion rate of 20 mL x kg(-1) x min(-1). CONCLUSIONS: Regional low-flow perfusion is a safe and simple bypass management technique that provides cerebral circulatory support during neonatal aortic arch reconstruction. The reduction of deep hypothermia and circulatory arrest time required may reduce the risk of cognitive and psychomotor deficits.
Authors:
F A Pigula; E M Nemoto; B P Griffith; R D Siewers
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  119     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-03-03     Completed Date:  2000-03-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  331-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatric Cardiothoracic Surgery, Children's Hospital of Pittsburgh, Pittsburgh, PA 15213, USA. Pigulaf@heart.chp.edu
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MeSH Terms
Descriptor/Qualifier:
Aorta, Thoracic / surgery*
Blood Volume
Brain / blood supply*,  metabolism
Brain Ischemia / prevention & control
Cerebrovascular Circulation
Heart Arrest, Induced
Heart Defects, Congenital / surgery*
Humans
Hypothermia, Induced
Infant
Infant, Newborn
Oxygen Consumption
Perfusion / methods*
Spectroscopy, Near-Infrared
Treatment Outcome
Vascular Surgical Procedures / methods*

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


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