title: Management of the Low Cardiac Output Syndrome Following Surgery for Congenital Heart Disease.
abstract: The purpose of this review is to discuss the management of the low cardiac output syndrome (LCOS) following surgery for congenital heart disease. The LCOS is a well-recognized, frequent post-operative complication with an accepted collection of hemodynamic and physiologic aberrations. Approximately 25% of children experience a decrease in cardiac index of less than 2 L/min/m2 within 6-18 hours after cardiac surgery. Post-operative strategies that may be used to manage patients as risk for or in a state of low cardiac output include the use of hemodynamic monitoring, enabling a timely and accurate assessment of cardiovascular function and tissue oxygenation; optimization of ventricular loading conditions; the judicious use of inotropic agents; an appreciation of and the utilization of positive pressure ventilation for circulatory support; and, in some circumstances, mechanical circulatory support. All interventions and strategies should culminate in improving the relationship between oxygen supply and demand, ensuring adequate tissue oxygenation.
authors.affiliation: Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin st. W6006, Houston, Texas, 77030, USA. hkchand1@texaschildrens.org.
authors.forename: Heather K
authors.initials: HK
authors.lastname: Chandler
authors.forename: Roxanne
authors.initials: R
authors.lastname: Kirsch
mesh_terms: D002303:Cardiac Output, Low / Q000503:physiopathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008991:Monitoring, Physiologic; D011183:Postoperative Complications