Therapeutic mild hypothermia on pediatric patients with low cardiac output syndrome after open heart surgery

  • Tatsuo Iwasaki, Okayama University Graduate School of Medicine and Dentistry, Japan
  • Yuichiro Toda, Okayama University Graduate School of Medicine and Dentistry, Japan
  • Kazuyoshi Shimizu, Okayama University Graduate School of Medicine and Dentistry, Japan
  • Tomohiko Suemori, Okayama University Graduate School of Medicine and Dentistry, Japan
  • Satoshi Suzuki, Okayama University Graduate School of Medicine and Dentistry, Japan
  • Kiyoshi Morita, Okayama University Graduate School of Medicine and Dentistry, Japan

    • Low cardiac output syndrome (LOS) following open heart surgery is not rare in pediatric patients. Mild hypothermia might be one of the useful therapeutic options to control LOS because myocardial contractility depends on temperature. But only a few report are available and we conducted this retrospective chart review to
    Material and method
    This was a retrospective study based on medical chart review of admissions to a university hospital. Twenty patients of 226 children who admitted to ICU after open heart surgery from January to August 2008 were enrolled to this study.
    Results
    All 20 patients were infants. Core temperature was controlled between 34 to 36 degrees C. Diagnoses included TAPVD(6), HLHS(5), IAA(2), CoA complex(2), others(5). The mean body weight of patients was 2.7(1.7-3.2)(median(range))kg, systolic blood pressure and base excess on admission to ICU were 55(35-110)mmHg, -1.1(-15.5-10.1)mmol/L respectively. Five patients required peritoneal dialysis, and 8 cases include 5 children of ECMO underwent delayed sternal closure. Two patients suffered from infectious complication. Two infants died from cardiac failure with infectious complication. Duration of mechanical ventilation was 182(61-2575) hours.
    Conclusion
    Therapeutic mild hypothermia might be useful to control LOS after open heart surgery, and required to pay attention to infectious comploication.