METABOLIC EFFECTS OF DEEP HYPOTHERMIA AND CIRCULATORY ARREST IN INFANTS DURING CARDIAC SURGERY

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Abstract
Twenty-one infants underwent surgical correction of severe cardiac abnormalities during deep hypothermia and circulatory arrest. Three died, two of uncorrectable lesions and one probably by wrong placement of an endotracheal tube during operation. Lactic acidosis was only slightly greater than that seen in our adult patients undergoing valve surgery during moderate hypothermia and continuous total body perfusion. Large metabolic acid-base shifts, not due to lactate or administered bicarbonate and apparently related to perfusion and temperature change, were seen, as in our adult patients. Measurement of oxygen uptake and calculation of lactacid oxygen debt suggested that 55 minutes of circulatory arrest was near to the maximal safe interval at 23°C. Post-operatively all but two of fifteen patients studied followed a satisfactory metabolic course without being artificially ventilated.

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