title: The effects of cardiopulmonary bypass and profound hypothermic circulatory arrest on anterior fontanel pressure in infants.
abstract: The Ladd transducer was used to measure anterior fontanel pressure in 23 infants undergoing cardiopulmonary bypass and profound hypothermic circulatory arrest for surgical correction of congenital heart disease. Mean (+/- SD) minimum oesophageal and rectal temperatures of 11.3 +/- 1.5 degrees C and 18.1 +/- 2.2 degrees C respectively were achieved with a mean duration of arrest of 53.4 +/- 13.9 minutes. During reperfusion cardiopulmonary bypass after circulatory arrest, mean anterior fontanel pressure (18.3 +/- 6.4 mmHg) increased above baseline pre-bypass values (10.6 +/- 2.9 mmHg) (p less than 0.005). Mean arterial blood pressure decreased significantly from pre-bypass values (57.0 +/- 11.8 mmHg) during both cooling (38.8 +/- 8.4 mmHg) and rewarming cardiopulmonary bypass (45.8 +/- 8.9 mmHg) (p less than 0.005). These changes were associated with a significant decrease in cerebral perfusion pressure during cooling (27.3 +/- 11.0 mmHg) and rewarming cardiopulmonary bypass (27.5 +/- 10.6 mmHg), compared with baseline pre-bypass values (46.5 +/- 12.3 mmHg) (p less than 0.005). The data demonstrate significant but transient decreases in cerebral perfusion pressure during cooling and rewarming bypass.
authors: Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario.
authors: P J
authors: PJ
authors: Stow
authors: F A
authors: FA
authors: Burrows
authors: M E
authors: ME
authors: McLeod
authors: J G
authors: JG
authors: Coles
mesh_terms: D002315:Cardiopulmonary Bypass; D003393:Cranial Sutures / Q000502:physiology*; D006324:Heart Arrest, Induced; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007036:Hypothermia, Induced; D007223:Infant; D007427:Intracranial Pressure; D012886:Skull / Q000502:physiology*