Issue |
J Extra Corpor Technol
Volume 18, Number 2, June 1986
|
|
---|---|---|
Page(s) | 140 - 144 | |
DOI | https://doi.org/10.1051/ject/1986182140 | |
Published online | 12 September 2023 |
Original Article
Refinements in Infant/Pediatric Perfusion
1
The Divisions of Cardiac Surgery, The Childrens Hospital; and Cardio-Thoracic Surgery, University of Colorado Health Sciences Center, Denver, CO
2
PSICOR, Inc., Brighton, MI
* Direct communications to: Richard Berryessa, C.C.P., PSICOR Inc., 810 East Grand River, Brighton, MI 48116
Little has been written in recent years to update the pediatric perfusion literature. This paper is a review of the perfusion techniques we use with 200 children a year in Denver and we believe it is a reflection of the state-of-the-art. We will discuss equipment selection (including a method of streamlining inventory), circuit prime, anticoagulation, temperature control, blood flow, myocardial protection, blood conservation, patient safety, and cost containment.
Deep hypothermia and circulatory arrest are used with most children under 8 Kg. and acid-base status is managed to maintain respiratory alkalosis with the help of on-line monitoring. Pulsatile flow is used on all patients and hollow fiber membrane oxygenators and blood cardioplegia are used on most. The choice of oxygenator size, and subsequent priming volume, is influenced by the decrease in gas exchange efficiency (− 20%) at this altitude and must be understood in that context. All other information is appropriate at any altitude and will be helpful to a team who does few pediatric cases or is starting up a program.
© 1986 AMSECT
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