Development of safe cardiopulmonary bypass system without use of homologous blood in neonates and infants

1999 Fiscal Year Final Research Report Summary

• Project/Area Number: 10671273
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Thoracic surgery
• Research Institution: Tokyo Women's Medical University
• Principal Investigator: AOKI Mitsuru Department of Pediatric Cardiovascular Surgery, Tokyo Women's Medical College, Assistant Professor, 医学部, 講師 (80175736)
• Project Period (FY): 1998 – 1999
• Keywords: Brain / Hemodilution / Cardiopulmonary bypass / Neonate / Infant / Open Heart Surgery

Research Abstract

Effects of cardiopulmonary bypass with extreme hemodilution (hemoglobin concentrations less than 5.0 g/dl) in pediatric open heart surgery were investigated.
In a animal model using the rabbit undergoing cardiopulmonary bypass, changes in oxygenation levels in intracranial hemoglobin and cytochrome C measured with near-infrared spectroscopy, and histological changes in the hippocampus CA1 area were studied. Yet not decisive the results suggested that the hemoglobin levels over 3.0 g/dl might be safe for cerebral protection during cardiopulmonary bypass. In a clinical study of infants undergoing open heart surgery the changes in oxygenation levels in intracranial hemoglobin and cytochrome C measured with near-infrared spectroscopy and in neurospecific protein S-100 are also investigated. In the study one case that had hemoglobin levels below 3.5 g/dl during moderately hypothermic cardiopulmonary bypass showed transient convulsion and a rise in protein S-100 early after the surgery.
These results suggest that hemoglobin levels above 3.5 g/dl should be maintained during cardiopulmonary bypass in pediatric patients.