Combination of Low-Dose Phenoxybenzamine and Sodium Nitroprusside in Children Undergoing Cardiac Surgery

Alpha-blockade during congenital heart surgery admissions: analysis from national database

“…Peri-operative use of alpha-blockade allows for higher cardiopulmonary bypass pump flows which has been associated with decreased peri-operative metabolic acidosis. 8,9,14 As previously shown, alpha-blockade may have a pulmonary vasodilating effect that can be of benefit in certain patient populations 6,7,[15][16][17][18] . Alphablockade has also been demonstrated to improve coronary flow.…”

“…Previous reports of the use of alphablockade in paediatric cardiac surgery admissions have shown favourable effects. [5][6][7][8][9][10] The univariate analyses demonstrate a pattern consistent with alpha-blockade being more frequently used in cardiac lesions palliated or repaired in the neonatal period such as double outlet right ventricle repair (Risk-adjustment Congenital Heart Surgery-1 category 3), hypoplastic left heart syndrome (Norwood procedure, Risk-adjustment Congenital Heart Surgery-1 category 6), transposition (arterial switch, Risk-adjustment Congenital Heart Surgery-1 category 4), common arterial trunk (truncus arteriosus repair, Risk-adjustment Congenital Heart Surgery-1 category 4), and total anomalous pulmonary venous connection repair (Risk-adjustment Congenital Heart Surgery-1 category 4). These findings are not particularly surprising as these neonatal palliations and repairs continue to represent the congenital heart surgery interventions with greatest morbidity and mortality according to the Risk-adjustment Congenital Heart Surgery-1 classification.…”