Induced hypothermia in the postoperative management of refractory cardiac failure following paediatric cardiac surgery

• Published in: Anaesthesia 1998-09, Vol.53 (9), p.848-853
• Main Authors: Deakin, C. D., Knight, H., Edwards, J. C., Monro, J. L., Lamb, R. K., Keeton, B., Salmon, A. P.
• Format: Article
• Language: English
• Subjects: Adolescent; Biological and medical sciences; Cardiac Output, Low - blood; Cardiac Output, Low - therapy; Cardiac Output, Low - urine; Child; Child, Preschool; Heart Defects, Congenital - surgery; Hemodynamics; Hospital Mortality; Humans; Hydrogen-Ion Concentration; Hypothermia; Hypothermia, Induced; Infant; Infant, Newborn; Leukocyte Count; Medical sciences; Platelet Count; Postoperative Care - methods; Postoperative Complications - blood; Postoperative Complications - therapy; Postoperative Complications - urine; Postoperative Period; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Surgery; cardiac, paediatric
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1046/j.1365-2044.1998.00563.x

Postoperative low cardiac output states are a major cause of postoperative mortality in infants and children following corrective cardiac surgery for congenital heart defects. In this unit, whole body hypothermia has been used since 1979 in the management of these low output states when they are refractory to conventional modes of therapy. Twenty cases treated in this way between July 1986 and June 1990 were reviewed in 1992. The current report reviews the 50 further cases treated with moderate hypothermia between July 1990 and December 1995. The median (range) age of patients was 8 months (0 days — 16 years) with a median weight of 4.1 kg (2.5–33 kg). Following cooling, there was a decrease in heart rate (p