The effect of hypothermic cardiopulmonary bypass and total circulatory arrest on cerebral metabolism in neonates, infants, and children

Intellectual development of infants, children and adolescents with congenital heart disease

“…Autoregulation of CBF may be impaired after DHCA (Greeley, Kern, Ungerleider, Boyd, Quill, Smith, Baldwin & Reves, 1991), resulting in the commonly occurring changes in blood pressure seen after cardiac surgery having a significant impact on cerebral perfusion. Management of body temperature may also influence cerebral perfusion (Mahle, 2001).…”

Static cerebrovascular pressure autoregulation remains intact during deep hypothermia

“…The historic studies of infant hypothermic bypass at The Hospital For Sick Children, Toronto, and Duke University, were done in the 1990s when anesthesia consisted of opioids and neuromuscular blockade. [10][11][12] The anesthetic used in this study included 0.8% isoflurane, which may limit comparison and conclusions. However, our study showed preserved autoregulation, and if the vapor anesthetic were to confound our data, one would predict it to cause impaired autoregulation.…”

“…Hypothermia during cardiopulmonary bypass is associated with impaired cerebrovascular auotregulation. [10][11][12][13] We previously presented a method to monitor cerebrovascular pressure autoregulation continuously using near-infrared spectroscopy in a cohort of patients with congenital heart disease during cardiopulmonary bypass. 14 Data from this cohort obtained during cardiopulmonary bypass showed impaired but not absent autoregulation when compared to the pre-bypass data.…”

Deep Brain Hyperthermia While Rewarming from Hypothermic Circulatory Arrest

“…This suggests a greater metabolic suppression by hypothermia in the pediatric population. 10 Postoperative hyperthermia has been linked to neurological impairment both after a neurological insult and following CPB. 2,3,7,11,12 Experimentally, in a canine stroke model, a 1 • C change in temperature altered neurological and histopathological outcomes.…”