[Venoarterial bypass in children with congenital heart disease--a retrospective study].
To investigate prognostic factors for patients supported by venoarterial (VA) bypass, we analyzed retrospectively 31 patients with congenital heart diseases supported by VA bypass between 1997 and 2000. Median age was 3.6 months and median body weight was 4.0 kg. Causes of VA bypass were difficult weaning from cardiopulmonary bypass in 8 patients, postoperative cardiac dysfunction in 5 and cardiopulmonary resuscitation in 18. Six (19.4%) of 31 patients were weaned successfully from VA bypass, and 2 (6.5%) survived to hospital discharge. In patients who were weaned from VA bypass successfully, VA bypass was instituted more quickly (41.6 +/- 5.0 vs 62.5 +/- 35.9 min), and good tissue perfusion was established in association with lower lactate levels at 12 hr (7.0 +/- 5.9 vs. 16.4 +/- 15.4 mmol.l-1) and larger urine output during first 24 h (81 +/- 68 vs. 22 +/- 43 ml.kg-1.day-1), compared to those who failed to be weaned. Major complications were intracranial hemorrhage in the newborn (50%), and hypoxic brain damage in patients with palliative operation (35%). It is necessary to establish guidelines of entry, weaning, and withholding of this support.
Tachibana
Kazuya
K
Department of Surgical Intensive Care Unit, National Cardiovascular Center, Osaka 565-8565.
Imanaka
Hideaki
H
Miyano
Hiroshi
H
Kagawa
Kiyokazu
K
Takeuchi
Muneyuki
M
Kumon
Keiji
K
D000293:Adolescent; D000328:Adult; D001243:Assisted Circulation / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D002534:Hypoxia, Brain / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000209:etiology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies