Cerebral oxygen saturation does not normalize until after stage 2 single ventricle palliation.

Background: In an effort to optimize neurologic outcome, cerebral oxygen saturation (SCO2) is often measured intraoperatively and postoperatively. We hypothesized that SCO2 would be related to stage of palliation in children with single ventricle congenital heart disease.

Methods: Cerebral oxygen saturation was continuously recorded intraoperatively in 34 infants and children undergoing palliative surgery on cardiopulmonary bypass for single ventricle congenital heart defects and in a control group of 12 neonates with ductus-dependent circulation undergoing complete repair.

The significance of baseline cerebral oxygen saturation in children undergoing congenital heart surgery.

Objectives: Despite recent significant improvement in outcome, children undergoing surgery for correction of congenital heart defects have a persistent and troublesome mortality rate and incidence of neurologic complications. Recent data suggest that some congenital heart defects are associated with abnormal brain development and with low cerebral blood flow. We hypothesized that some children with congenital heart disease have an abnormally low baseline (preoperative) cerebral oxygen saturation (ScO2).

Extended support with the Terumo Baby-RX oxygenator.

The Terumo Baby-RX, a new-generation low prime oxygenator, recently has entered the perfusion market in North America. This oxygenator is designed exclusively for neonates and infants and has the smallest priming volume of any clinically available oxygenator. The BABY-RX also is treated with X Coating, Terumo's biocompatible, hydrophilic polymer surface coating that reduces platelet adhesion and protein denaturation.

A technique for performing antegrade selective cerebral perfusion without interruption of forward flow or cannula relocation for pediatric aortic arch reconstruction.

New technology and advances in extracorporeal bypass circuitry and surgical techniques have drastically improved outcomes in infants with congenital heart defects. Hypothermia with circulatory arrest has fallen out of favor in many institutions over the last decade in part from data implicating even short circulatory arrest times to long-term neurologic sequelae. Implementing continuous cerebral perfusion techniques for aortic arch reconstruction is desirable in ameliorating neurologic complications because long-term survival of complex defects can be more routinely achieved.

Modified ultrafiltration postextracorporeal membrane oxygenation.

Modified ultrafiltration (MUF) has been widely used for the removal of extracellular water in the immediate postcardiopulmonary bypass (CPB) period. The reported benefits of this technique are improved hematological status and hemodynamic stability post-CPB, as well as a decrease in blood utilization during the operation. MUF has also been associated with improved pulmonary status along with enhanced myocardial performance.