Management of extracorporeal circulation in neonates with open heart operation

Lin Jian-bing; Ruan Xiu-xuan

doi:10.13498/j.cnki.chin.j.ecc.2015.02.10

Abstract：Objective To summarize the experience of extracorporeal circulation management of neonates with open heart oper?ation. Methods We reviewed the clinical protocols of extracorporeal circulation ( ECC) in 28 neonates with open heart operation in Fujian Provincial Hospital from April 2013 to December 2014. The neonates included 16 males and 12 females. The patients were aged from 7 to 28 days ,with a median of(13.8±9.6) days;and their weights ranged from 2.5 to 5 kg, with a median of (3.8±0.9) kg. All cases underwent cardiac operation with ECC and general anesthesia. The study included 2 cases underwent normal temperature ECC on?beating heart,16 cases received normal temperature with cardiac arrest,10 cases with moderate hypothermia circulatory arrest and selec?tion cerebral perfusion. Histidine-tryptophan-ketoglutarate ( HTK) solution was used for myocardial protection. Conventional ultra fil?tration ( CUF) and warm-keeping modified ultra filtration were applied for all patients as well. Zero-balance ultra filtration was also used when necessary. Results The ECC time was 50~200 min with an average of 135±54 min, aorta cross clamping time ranged from 0~188 min with a median time of 105 ± 68 min. The heartbeat recovered spontaneously in all patients after cross clamping release ( CCR) , all patients were successfully weaned from ECC. There were two hospital deaths ( 6.7%) . Conclusion The management of extracorporeal circulation in neonates has specifial significance. Reasonable fine and optimal management of each link during extracor?poreal circulation is critical to the success of the operation.