Mechanical aspects of pediatric cardio pulmonary bypass

Abstract

Cardiopulmonary bypass during cardiac surgery provides a safe, reliable platform for cardiopulmonary support. For the surgeon, a motionless, bloodless operative field is critical to complete a successful cardiac repair. Patients undergoing cardiac surgery are at risk of major organ system sequelae due to numerous physiologic insults from the artificial surfaces and conditions resulting from cardiopulmonary bypass circuitry. Some of these insults include hemodilution, hypothermia, exposure to foreign materials, non-pulsatile flow, and nonphysiologic shear stresses. Patients may experience systemic inflammatory response syndrome and coagulation derangement that can lead to major organ dysfunction and clinical bleeding. Understanding these conditions allows for the clinician to ameliorate these effects and provide improved outcomes in this delicate patient population. This chapter will overview the mechanical aspect of cardiopulmonary bypass in children.