INDUCED MODERATE HYPOTHERMIA FOR LOW CARDIAC OUTPUT AFTER PEDIATRIC CARDIAC SURGERY

Postoperative low cardiac output states are a major cause of postoperative mortality in infants and children following corrective cardiac surgery or congenital heart defects. Whole body hypothermia has been used since 2001 in the management of these low output states when they are refractory to conventional modes of therapy. From December 2001 to April 2006, 25 cases were included in this study. The median (range) age of patients was 36.6 months (1 mo-19 y) with a median weight of 12.2 kg (3.5-44 kg). Following cooling, there was a decrease in heart rate (P< 0.001), an increase in mean arterial pressure (P< 0.001) and a decrease in mean arterial pressure (P< 0.001). Significant increases in pH and urine output were also noticed, the increase in urine output being greater in the surviving group (P= 0.02). A decrease in platelet count was occurred (P< 0.001) but WBC count remained unchanged (P= 0.18). Fifteen of 25 patients survived to leave hospital. Induced hypothermia does not appear to be associated with any complications and after the failure of all conventional treatments, it seems likely that the technique may have been beneficial to outcome in some patients.