International Perfusion Association


Category: Pediatric

Pedi Pump

Perfusion Techniques for an 800 g Premature Neonate Undergoing Arterial Switch Procedure for Transposition of the Great Arteries

This article highlights the groundbreaking success in utilizing cardiopulmonary bypass (CPB) techniques for congenital heart surgery in premature neonates weighing less than 1000 g. Focusing on a case of a 28-week-old, 800 g neonate with transposition of the great arteries, the study discusses the challenges and innovations in perfusion techniques. Miniaturization of the CPB circuit, careful management of patient-to-circuit ratios, pharmacological distribution volumes, pressure gradients, and meticulous physiological environment control were key to mitigating risks such as volume shifts, electrolyte imbalance, and intracranial hemorrhage. This report underscores the feasibility and critical adjustments needed for successful CPB in extremely low birth weight neonates.

Perfusion Heart

Statistics in the Operating Room: A Cardiovascular Surgeon’s Guide to Numbers That Matter

This editorial emphasizes the critical role of statistical analysis in pediatric cardiac surgery, highlighting how surgeons can use statistical tools to improve patient outcomes. It covers the importance of descriptive statistics, hypothesis testing, regression analysis, and survival analysis in crafting personalized treatment plans. By integrating statistical data, surgeons can make informed decisions, enhancing the success of surgeries and the well-being of their young patients.

Dialysis 123

Outcomes of Prophylactic Peritoneal Dialysis Catheter Insertion in Children Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis evaluated the association between prophylactic peritoneal dialysis (PD) catheter insertion during pediatric cardiac surgery and improved short-term outcomes. Analyzing seventeen studies, including four randomized controlled trials, the study found no significant link between prophylactic PD catheter insertion and reduced in-hospital mortality. Results for ICU stay length and time to achieve negative fluid balance were inconclusive, with some studies indicating benefits and others showing no difference. The analysis highlights the need for further research on short-term outcomes and fluid overload markers in this context, acknowledging the high risk of bias in the included studies.

CV Surgery Baby

Intra-abdominal Hypertension Predicts Worse Hospital Outcomes in Children After Cardiac Surgery: A Pilot Study

This study highlights the incidence and impact of postoperative intra-abdominal hypertension (IAH) in children undergoing open-heart surgery, showing that 24.7% of patients experienced IAH, with significant occurrences within the first 24 hours of ICU admission. Factors like right-sided heart lesions, redo sternotomies, and prolonged cardiopulmonary bypass were identified as predictors of IAH. The condition was associated with increased inotropic support needs, gastrointestinal complications, sepsis, multiple organ dysfunction syndrome, and extended stays in the ICU and hospital. This underscores the importance of monitoring and managing IAH to improve postoperative outcomes in pediatric cardiac surgery patients

Blood CPG

Randomized Controlled Trial of Remote Ischemic Preconditioning in Children Having Cardiac Surgery

In a study on children undergoing cardiac surgery, remote ischemic preconditioning showed a potential for reducing kidney injury, but there were no significant differences in cardiac markers or secondary clinical outcomes. Although there was a minor trend towards kidney protection, larger studies are needed to confirm the efficacy of this intervention in a high-risk pediatric population.


Impact of Pre-Bypass Ultrafiltration on Prime Values and Clinical Outcomes in Neonatal and Infant Cardiopulmonary Bypass

Pre-bypass Ultrafiltration (PBUF) was found to standardize and make more physiologic the values for electrolytes, glucose, and lactate in blood primes used for cardiopulmonary bypass in congenital cardiac surgery, without significantly affecting in-hospital outcomes. This retrospective study compared patients ≤ 1 year old undergoing cardiac surgery with PBUF to those without, showing significant improvements in the physiologic values of PBUF-treated circuits.


An in vitro Comparison of Intra-Operative Isohemagglutinin and Human Leukocyte Antigen Removal Techniques in Pediatric Heart Transplantation

This study compared two plasmapheresis techniques, membrane-based (MP) and centrifuge-based (CP), for their effectiveness in reducing isohemagglutinin titers (IT) and human leukocyte antigen (HLA) antibodies in highly sensitized pediatric patients awaiting heart transplants. Both methods, incorporated into extracorporeal circuits, effectively reduced circulating antibodies, with CP showing slightly greater efficiency in reducing ITs and anti-HLA class II antibody mean fluorescence intensity, although further in vivo studies are needed for confirmation.

Pediatric ECPR

ECPR for Prolonged Pediatric Cardiac Arrest, an Autcome Without Major Neurological Compromise

Pediatric in-hospital cardiac arrest (IHCA) occurs in 1-6% of pediatric ICU admissions, with survival rates improving from 9% to 35% over the past 25 years, partly due to the use of ECMO as a rescue strategy. A case is reported of a 4-month-old patient with ventricular and septal defects who underwent surgery, experienced complications leading to a prolonged cardiac arrest, and was successfully treated with ECMO.


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