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Author(s) -
Reid Jeff,
Mayhew James F.
Publication year - 2010
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2010.03304.x
Subject(s) - anesthesiology , medicine , citation , library science , perioperative , center (category theory) , surgery , anesthesia , computer science , chemistry , crystallography
International audienceBackground: 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 female, 5 male). 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: 1. baseline I, 2. VVI pacing, 3. baseline II, and 4. atrial pacing (AOO) in order 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. Results: VVI 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 µmol/l to –2.9 ± 4.7 µmol/l (p< 0.05)). Conclusion: Cardiac desynchronization after CPB seems to reduce cerebral blood flow and cerebral oxygenation in children