Cerebral vascular effects of aortovenous cannulations for pediatric cardiopulmonary bypass
The effects of aortovenous cannulations for pediatric cardiopulmonary bypass on cerebral blood flow velocity (CBFV) and electroencephalography (EEG) were evaluated. CBFV and EEG were continuously recorded before (baseline), during, and after cannulations until initiation of cooling (mean +/- 95% con...
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Veröffentlicht in: | The Annals of thoracic surgery 2000-04, Vol.69 (4), p.1229-1235 |
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description | The effects of aortovenous cannulations for pediatric cardiopulmonary bypass on cerebral blood flow velocity (CBFV) and electroencephalography (EEG) were evaluated.
CBFV and EEG were continuously recorded before (baseline), during, and after cannulations until initiation of cooling (mean +/- 95% confidence interval). Vasopressors and/or volume replacement were administered if mean arterial pressure (MAP) decreased below 35 mm Hg. Cannulation-related EEG slowing was used as a criterion for electrocortical alteration.
We studied 124 children (3 days to 17 years of age). Aortic and venous cannulations decreased mean CBFV by 10+/-3% and 13+/-4%, respectively, from baseline (p < 0.001). MAP diminished (p < 0.01) by 8+/-3% and 12+/-4%, respectively, from precannulation values (53+/-2 mm Hg). Right atrial cannulation, which was often chosen because the patient was hemodynamically unstable, was more frequently associated with pharmacologic intervention when compared with superior vena cava (SVC) cannulation (p < 0.01). Transient EEG alterations (n = 20) were associated with persistently low MAP (< 30 mm Hg), low CBFV (< 69%), and aortic (n = 4) or SVC (n = 7) cannula malposition. Infants with right atrial cannulation and intervention had more frequent EEG alterations (p = 0.04). Patients requiring intervention were younger (p < 0.01) and had longer hospital stay (p < 0.01) than those without intervention.
Cerebral effects of cannulations are greater in young infants. This was found to be associated with low MAP during heart manipulation or consequence of cannula malpositions. |
doi_str_mv | 10.1016/S0003-4975(99)01444-7 |
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CBFV and EEG were continuously recorded before (baseline), during, and after cannulations until initiation of cooling (mean +/- 95% confidence interval). Vasopressors and/or volume replacement were administered if mean arterial pressure (MAP) decreased below 35 mm Hg. Cannulation-related EEG slowing was used as a criterion for electrocortical alteration.
We studied 124 children (3 days to 17 years of age). Aortic and venous cannulations decreased mean CBFV by 10+/-3% and 13+/-4%, respectively, from baseline (p < 0.001). MAP diminished (p < 0.01) by 8+/-3% and 12+/-4%, respectively, from precannulation values (53+/-2 mm Hg). Right atrial cannulation, which was often chosen because the patient was hemodynamically unstable, was more frequently associated with pharmacologic intervention when compared with superior vena cava (SVC) cannulation (p < 0.01). Transient EEG alterations (n = 20) were associated with persistently low MAP (< 30 mm Hg), low CBFV (< 69%), and aortic (n = 4) or SVC (n = 7) cannula malposition. Infants with right atrial cannulation and intervention had more frequent EEG alterations (p = 0.04). Patients requiring intervention were younger (p < 0.01) and had longer hospital stay (p < 0.01) than those without intervention.
Cerebral effects of cannulations are greater in young infants. This was found to be associated with low MAP during heart manipulation or consequence of cannula malpositions.]]></description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(99)01444-7</identifier><identifier>PMID: 10800824</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Science</publisher><subject>Adolescent ; Biological and medical sciences ; Blood Pressure ; Cardiac Catheterization ; Cardiopulmonary Bypass ; Cerebrovascular Circulation ; Child ; Child, Preschool ; Electroencephalography ; Heart Defects, Congenital - surgery ; Hemodynamics ; Humans ; Infant ; Infant, Newborn ; Medical sciences ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart</subject><ispartof>The Annals of thoracic surgery, 2000-04, Vol.69 (4), p.1229-1235</ispartof><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-68fca2b98473c1b7ffd95c473094b37c4cec6e32241ec9301b202ae2ca6cc3433</citedby><cites>FETCH-LOGICAL-c417t-68fca2b98473c1b7ffd95c473094b37c4cec6e32241ec9301b202ae2ca6cc3433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1350480$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10800824$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>RODRIGUEZ, R. A</creatorcontrib><creatorcontrib>CORNEL, G</creatorcontrib><creatorcontrib>SPLINTER, W. M</creatorcontrib><creatorcontrib>WEERASENA, N. A</creatorcontrib><creatorcontrib>REID, C. W</creatorcontrib><title>Cerebral vascular effects of aortovenous cannulations for pediatric cardiopulmonary bypass</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description><![CDATA[The effects of aortovenous cannulations for pediatric cardiopulmonary bypass on cerebral blood flow velocity (CBFV) and electroencephalography (EEG) were evaluated.
CBFV and EEG were continuously recorded before (baseline), during, and after cannulations until initiation of cooling (mean +/- 95% confidence interval). Vasopressors and/or volume replacement were administered if mean arterial pressure (MAP) decreased below 35 mm Hg. Cannulation-related EEG slowing was used as a criterion for electrocortical alteration.
We studied 124 children (3 days to 17 years of age). Aortic and venous cannulations decreased mean CBFV by 10+/-3% and 13+/-4%, respectively, from baseline (p < 0.001). MAP diminished (p < 0.01) by 8+/-3% and 12+/-4%, respectively, from precannulation values (53+/-2 mm Hg). Right atrial cannulation, which was often chosen because the patient was hemodynamically unstable, was more frequently associated with pharmacologic intervention when compared with superior vena cava (SVC) cannulation (p < 0.01). Transient EEG alterations (n = 20) were associated with persistently low MAP (< 30 mm Hg), low CBFV (< 69%), and aortic (n = 4) or SVC (n = 7) cannula malposition. Infants with right atrial cannulation and intervention had more frequent EEG alterations (p = 0.04). Patients requiring intervention were younger (p < 0.01) and had longer hospital stay (p < 0.01) than those without intervention.
Cerebral effects of cannulations are greater in young infants. This was found to be associated with low MAP during heart manipulation or consequence of cannula malpositions.]]></description><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure</subject><subject>Cardiac Catheterization</subject><subject>Cardiopulmonary Bypass</subject><subject>Cerebrovascular Circulation</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Electroencephalography</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Medical sciences</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkMtKxDAUhoMozjj6CEoXIrqonlx6yVIGbzDgQt24CelpApVOU5N2YN7ezAV1dTj837nwEXJO4ZYCze_eAICnQhbZtZQ3QIUQaXFApjTLWJqzTB6S6S8yISchfMWWxfiYTCiUACUTU_I5N95UXrfJSgccW-0TY63BISTOJtr5wa1M58aQoO66mA-N60JinU96Uzd68A3GyNeN68d26Trt10m17nUIp-TI6jaYs32dkY_Hh_f5c7p4fXqZ3y9SFLQY0ry0qFklS1FwpFVhbS0zjA1IUfECBRrMDWdMUIOSA60YMG0Y6hyRC85n5Gq3t_fuezRhUMsmoGlb3Zn4uCooSJpDHsFsB6J3IXhjVe-bZXxYUVAbqWorVW2MKSnVVqoq4tzF_sBYLU39b2pnMQKXeyA61K31usMm_HE8A1EC_wGFRID7</recordid><startdate>20000401</startdate><enddate>20000401</enddate><creator>RODRIGUEZ, R. A</creator><creator>CORNEL, G</creator><creator>SPLINTER, W. M</creator><creator>WEERASENA, N. A</creator><creator>REID, C. W</creator><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000401</creationdate><title>Cerebral vascular effects of aortovenous cannulations for pediatric cardiopulmonary bypass</title><author>RODRIGUEZ, R. A ; CORNEL, G ; SPLINTER, W. M ; WEERASENA, N. A ; REID, C. W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-68fca2b98473c1b7ffd95c473094b37c4cec6e32241ec9301b202ae2ca6cc3433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure</topic><topic>Cardiac Catheterization</topic><topic>Cardiopulmonary Bypass</topic><topic>Cerebrovascular Circulation</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Electroencephalography</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Medical sciences</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>RODRIGUEZ, R. A</creatorcontrib><creatorcontrib>CORNEL, G</creatorcontrib><creatorcontrib>SPLINTER, W. M</creatorcontrib><creatorcontrib>WEERASENA, N. A</creatorcontrib><creatorcontrib>REID, C. W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>RODRIGUEZ, R. A</au><au>CORNEL, G</au><au>SPLINTER, W. M</au><au>WEERASENA, N. A</au><au>REID, C. W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebral vascular effects of aortovenous cannulations for pediatric cardiopulmonary bypass</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2000-04-01</date><risdate>2000</risdate><volume>69</volume><issue>4</issue><spage>1229</spage><epage>1235</epage><pages>1229-1235</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract><![CDATA[The effects of aortovenous cannulations for pediatric cardiopulmonary bypass on cerebral blood flow velocity (CBFV) and electroencephalography (EEG) were evaluated.
CBFV and EEG were continuously recorded before (baseline), during, and after cannulations until initiation of cooling (mean +/- 95% confidence interval). Vasopressors and/or volume replacement were administered if mean arterial pressure (MAP) decreased below 35 mm Hg. Cannulation-related EEG slowing was used as a criterion for electrocortical alteration.
We studied 124 children (3 days to 17 years of age). Aortic and venous cannulations decreased mean CBFV by 10+/-3% and 13+/-4%, respectively, from baseline (p < 0.001). MAP diminished (p < 0.01) by 8+/-3% and 12+/-4%, respectively, from precannulation values (53+/-2 mm Hg). Right atrial cannulation, which was often chosen because the patient was hemodynamically unstable, was more frequently associated with pharmacologic intervention when compared with superior vena cava (SVC) cannulation (p < 0.01). Transient EEG alterations (n = 20) were associated with persistently low MAP (< 30 mm Hg), low CBFV (< 69%), and aortic (n = 4) or SVC (n = 7) cannula malposition. Infants with right atrial cannulation and intervention had more frequent EEG alterations (p = 0.04). Patients requiring intervention were younger (p < 0.01) and had longer hospital stay (p < 0.01) than those without intervention.
Cerebral effects of cannulations are greater in young infants. This was found to be associated with low MAP during heart manipulation or consequence of cannula malpositions.]]></abstract><cop>New York, NY</cop><pub>Elsevier Science</pub><pmid>10800824</pmid><doi>10.1016/S0003-4975(99)01444-7</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adolescent Biological and medical sciences Blood Pressure Cardiac Catheterization Cardiopulmonary Bypass Cerebrovascular Circulation Child Child, Preschool Electroencephalography Heart Defects, Congenital - surgery Hemodynamics Humans Infant Infant, Newborn Medical sciences Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart |
title | Cerebral vascular effects of aortovenous cannulations for pediatric cardiopulmonary bypass |
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