The effect of duration of cardiopulmonary bypass on hemodynamics and sedative status after postoperative administration of dexmedetomidine in pediatric patients with congenital heart disease

  • Dr Mitsugi Nagashima, Japan
  • Fumiaki Shikata, Department of Surgery, Stroke & Cardiovascular Center, Ehime University Hospital, Japan
  • Masahiro Ryugo, Department of Surgery, Stroke & Cardiovascular Center, Ehime University Hospital, Japan
  • Hiroshi Imagawa, Department of Surgery, Stroke & Cardiovascular Center, Ehime University Hospital, Japan
  • Eiichi Yamamoto, Department of Pediatric Cardiology, Stroke & Cardiovascular Center, Ehime University Hospital, Japan
  • Masaaki Ohta, Department of Pediatric Cardiology, Stroke & Cardiovascular Center, Ehime University Hospital, Japan
  • Takashi Higaki, Department of Pediatric Cardiology, Stroke & Cardiovascular Center, Ehime University Hospital, Japan
  • Kanji Kawachi, Department of Surgery, Stroke & Cardiovascular Center, Ehime University Hospital, Japan

    • Purpose: The aim of this study was to evaluate of the effect of the duration of cardiopulmonary bypass (CPB) on hemodynamics, respiratory condition and sedative state after continuous dexmedetomidine administration.
    Method: Dexmedetomidine (0.5 μg/kg/hr) was continuously administrated for postoperative sedation in 55 pediatric patients (range 1 months to 5 years) who underwent cardiac surgery. Patients were divided into two groups depending on the duration of CPB. Twenty eight patients who had undergone CPB over 2 hours were eligible into long CPB duration group (Group L) and the remaining 27 patients were placed into short duration group (Group S). Arterial systolic and diastolic pressure, heart rate, respiratory rate and sedative score (Ramsay score) were measured pre, 1 and 3 hours after administration.
    Results: Average duration of CPB were 180 ± 41 minutes in group L and 68 ± 25 minutes in group S. Average age was 1.4 years old in group L and 1.8 in group S. Percent change in systolic but not diastolic arterial pressure from pre-administration was significantly (p < 0.05, repeated measured ANOVA) decreased in group L compared with group S. Percent change in heart rate was significantly (p < 0.05) decreased in group S compared with group L. Percent change of respiratory rate increased along time course in both groups. Sedative state did not change in both groups during administration
    Conclusion: Postoperative continuous administration of dexmedetomidine could modify hemodynamics depending on the duration of CPB in pediatric patients and it did not suppress respiratory function and maintained good sedative status postoperatively.