Objective To summarize and analyze the experience of extracorporeal circulation (ECC) management in infantsbelow 5 kg who underwent the open heart operation. Methods Systematic review and summarization were made in the ECC management methods carried out in 98 infants below 5 kg who received the open heart operation in our department from 2009 to 2011. All patients received the intracardiac malformation correction under the general anaesthesia ECC and also the combination -ultrafiltration. Among those patients, 81 ones received the superficial - hypothermy and high flow; 15 received profound hypothermia and low flow; 2 ones received the profound hypothermia and circulatory arrest. Results No death happened during the operation. The ECC bypass time was 50 - 120 minutes. The aorta - block time was 25 - 90 minutes. And the time of circulatory arrest in the 2 cases was 20 and 22 minute, respectively. The time of low flow perfusion in 15 cases was 35 - 55 minutes. All patients obtained the heart resuscitation after the opening of the aorta, and the ECC was successfully detached. Three cases died after the operation, and it was identified that their death was not correlated directly with the ECC. Conclusion Management of consumptive materials, pre - filling, perfusion, and organprotection should be strengthened in the ECC of infants with congenital cardiopathy who were below the weight of 5 kg in order to reduce the occurrence of postoperative complications and the death rate.%目的 总结及探讨5 kg以下低体重患儿心内直视手术的体外循环(ECC)管理经验.方法 系统性回顾、总结我科2009～2011年98例5 kg以下低体重婴幼儿心内直视手术的ECC管理方法.所有患儿均在全麻ECC下完成心内畸形矫治手术,均进行联合超滤.其中浅低温高流量81例,深低温低流量15例,深低温停循环2例.结果 本组患儿无术中死亡.ECC转流时间为50～120 min,主动脉阻断时间为25～90 min；2例停循环时间分别为20、22 min; 15例低流量灌注时间为35～55 min.所有病例在开放主动脉后心脏均自动复跳,并成功脱离ECC.术后死亡3例,均证实与ECC无直接关系.结论 应加强5 kg以下婴幼儿先心病ECC中耗材、预充、灌注、脏器保护等方面的管理,以减少术后并发症及病死率.
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