Trends and Updates on Cardiopulmonary Bypass Setup in Pediatric Cardiac Surgery

J Cardiothorac Vasc Anesth. 2019 Oct;33(10):2804-2813. doi: 10.1053/j.jvca.2019.01.025. Epub 2019 Jan 9.

Abstract

Perfusion strategies for cardiopulmonary bypass have direct consequences on pediatric cardiac surgery outcomes. However, inconsistent study results and a lack of uniform evidence-based guidelines for pediatric cardiopulmonary bypass management have led to considerable variability in perfusion practices among, and even within, institutions. Important aspects of cardiopulmonary bypass that can be optimized to improve clinical outcomes of pediatric patients undergoing cardiac surgery include extracorporeal circuit components, priming solutions, and additives. This review summarizes the current literature on circuit components and priming solution composition with an emphasis on crystalloid, colloid, and blood-based primes, as well as mannitol, bicarbonate, and calcium.

Keywords: pediatric cardiac surgery; pediatric perfusion; perfusion.

Publication types

  • Review

MeSH terms

  • Albumins / adverse effects
  • Albumins / pharmacology
  • Cardiac Surgical Procedures / methods
  • Cardiac Surgical Procedures / trends*
  • Cardioplegic Solutions
  • Cardiopulmonary Bypass / instrumentation
  • Cardiopulmonary Bypass / methods*
  • Cardiopulmonary Bypass / trends*
  • Child
  • Crystalloid Solutions
  • Drainage / methods
  • Equipment Design
  • Humans
  • Infusion Pumps
  • Surface Properties

Substances

  • Albumins
  • Cardioplegic Solutions
  • Crystalloid Solutions