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Semin Cardiothorac Vasc Anesth · Mar 2007
ReviewBleeding following deep hypothermia and circulatory arrest in children.
- Emad B Mossad, Sandra Machado, and John Apostolakis.
- Department of Cardiothoracic Anesthesia-G3, Cleveland Clinic, Cleveland, OH 44195, USA. mossade@ccf.org
- Semin Cardiothorac Vasc Anesth. 2007 Mar 1; 11 (1): 34-46.
AbstractDeep hypothermic circulatory arrest (DHCA) is a technique of extracorporeal circulation commonly used in children with complex congenital heart defects undergoing surgical repairs. The use of profound cooling (20 degrees C) and complete cessation of circulation allow adequate exposure and correction of these complex lesions, with enhanced cerebral protection. However, the profound physiologic state of DHCA results in significant derangement of the coagulation system and a high incidence of postoperative bleeding. This review examines the impact of DHCA on bleeding and transfusion requirements in children and the pathophysiology of DHCA-induced platelet dysfunction. It also focuses on possible pharmacologic interventions to decrease bleeding following DHCA in children.
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