• Ross M Ungerleider and Irving Shen.
• Department of Cardiac Surgery, Oregon Health & Science University, Doernbecher's Children's Hospital, Portland, OR 97201-3098, USA.
• Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2003 Jan 1;6:140-6.

AbstractDespite the ability to surgically correct complex defects in neonates and infants, limitations in outcome are sometimes encountered in relation to exposure to cardiopulmonary bypass (CPB). The deleterious effects of CPB in neonates are often pronounced because of their immature tissue/organ function and the disparity between the CPB circuit size and the patient. A variety of techniques that have been developed to prevent or lessen tissue edema, including miniaturization of the circuit and oxygenator, prime additives (eg, albumin, steroids), biocompatible circuitry, and variations in perfusion strategies, are discussed as are post-CPB strategies such as modified ultrafiltration, which removes inflammatory mediator-rich fluid from the patient and bypass circuit. With optimization of the response of the infant to our systems used during repair of their cardiac lesion, we will see significant improvement in surgical outcomes.Copyright 2003 Elsevier, Inc. All rights reserved.

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