Cardiovascular Perfusion

Cardiopulmonary bypassCardiopulmonary Bypass (CPB) in congenital heart diseaseCongenital heart disease offers particular challenges due to both the size and age-range of the patients as well as the spectrum of morphologyMorphology in both arterial and venous arrangements, which can require specific cannulation strategies. Patients with cyanotic circulations need careful attention to Haematocrit management. CPB is very safe in childrenChildren and the focus is on reducing the morbidity associated with pediatricPediatric surgery and CPB: the systemic inflammatory response, the effects of hypothermia, altered perfusionPerfusion, hemodilution, acid-base management and embolization. Infants and neonates present additional challenges due to their small size, immature organ systems and altered physiology—they have a higher metabolic rate requiring higher pump flow rates per kg compared to an adult, and an impaired thermoregulatory response with greater dependence upon environmental temperature. Current perfusionPerfusion management is characterised by extensive monitoring systems, smaller volume components andModified Ultra-FiltrationpH stat minimising inflammatory responses with techniques such as modified ultrafiltration.