Cardiopulmonary bypass in infants

摘要

THE INCIDENCE of congenital heart defects is approximately 7 to 10 per 1,000 live births.1 With advancing technology and improved diagnostic, surgical, anesthetic, and postoperative management protocols, the tendency today is to perform the complete repair of defects early in infancy.1 Infancy is defined as the period from birth until age 1. The management of cardiopulmonary bypass (CPB) in infancy has many challenges and increased risk of morbidity and mortality compared with that of the adult population. Infants are more prone to complications because of the immaturity of their organ systems. There is a need for a more complete understanding of the anatomic, metabolic, and physiologic differences between infants and adults, and patient care must be individualized considering the degree of hemodilution and hypothermia, acid-base strategies, flow rates, circuit designs, priming the pump, and choice of cannulae.