The anesthesia management for cardiac procedures in infants of low body weight with cyanoticcongenital heart disease

Feng Long; Chen Ting-ting; Zhou Qi; Wang Wen-rui; Wu Shu-ling; Wang Gang

doi:10.13498/j.cnki.chin.j.ecc.2015.04.11

Abstract：Objective To summarize the anesthesia management strategies for cardiac procedures in infants of low body weight with cyanotic congenital heart disease. Methods Twenty six infants [9(3-24)Mouth, Weight 7.73±1.8(3.4-10)kg] received surgi?calrepair of cyanotic congenital heart disease fromMay 2012 to December 2014were retrospectively analyzed. All received fast track in?duction and totally intra-venous anesthetic maintenance and continuous monitoring of the invasive blood pressure and the central venous pressure during the operation was conducted. The data of cardiopulmonary bypass and aortic cross clamping times, transfusion, me?chanical ventilation times, complications and mortality was recorded during the perioperative period. Results All infants were smooth?ly operated on.The mean cardiopulmonary bypass time was 133.8±28.4 min, and aortic cross clamping time was 92.2±23 min. After the operation, the mechanical ventilation support was continued 73.7 (6.8-211.5)hours. low cardiac output syndromes occurred in 5 in?fants and 4 cases of pneumothorax, 4 cases of peritoneal dialysis and 3 cases of reintubation were noted and no infants died post-opera?tively. Conclusion The infants of low body weight with the complicated cyanotic congenital heart disease have critically illcondition before the operation. Reasonable management to regulation the bypass direction and volumes to maintain the satisfactory oxygenation and hemodynamic stability, while avoidingpulmonary complication and low cardiac output syndrome postoperatively, are the key points to ensure perioperative security and improve patient's prognosis.