A Review of Goal-Directed Cardiopulmonary Bypass Management in Pediatric Cardiac Surgery

Ravi Medikonda, Chin Siang Ong, Rajeev Wadia, Dheeraj Goswami, Jamie Schwartz, Larry Wolff, Narutoshi Hibino, Luca Vricella, Viachaslau Barodka, Jochen Steppan

Research output: Contribution to journalReview articlepeer-review

Abstract

Cardiopulmonary bypass perfusion management significantly affects postoperative outcomes. In recent years, the principles of goal-directed therapy have been applied to the field of cardiothoracic surgery to improve patient outcomes. Goal-directed therapy involves continuous peri- and postoperative monitoring of vital clinical parameters to tailor perfusion to each patient's specific needs. Closely measured parameters include fibrinogen, platelet count, lactate, venous oxygen saturation, central venous oxygen saturation, mean arterial pressure, perfusion flow rate, and perfusion pulsatility. These parameters have been shown to influence postoperative fresh frozen plasma transfusion rate, coagulation state, end-organ perfusion, and mortality. In this review, we discuss the recent paradigm shift in pediatric perfusion management toward goal-directed perfusion.

Original languageEnglish (US)
Pages (from-to)565-572
Number of pages8
JournalWorld journal for pediatric & congenital heart surgery
Volume9
Issue number5
DOIs
StatePublished - Sep 1 2018

Keywords

  • goal-directed perfusion
  • pediatric cardiac surgery
  • perfusion

ASJC Scopus subject areas

  • Medicine(all)

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