Acute renal failure in an infant attributable to arterial cannula malposition during cardiopulmonary bypass via ministernotomy

Junko Murakami, Ken Yamaura, Takashi Akata, Shosuke Takahashi

研究成果: ジャーナルへの寄稿学術誌査読

1 被引用数 (Scopus)

抄録

A 6-month-old female (4.9 kg) with multiple congenital heart lesions underwent intracardiac repair with the aid of cardiopulmonary bypass (CPB) through a lower half sternotomy. Aortic cannulation, venous cannulation, and cardioplegia cannula insertion were all accomplished through the ministernotomy. During the CPB, in spite of a high perfusion flow rate (182 ml · kg -1 · min -1 ), the systemic arterial pressure was persistently low (mean values = 25-35 mmHg) and the urine output was greatly reduced (<ml · hr -1 ). In addition, inappropriate increases in the arterial inflow line pressure were recognized. Since abutment of the cannula tip against the aortic intima was suspected, several attempts were made to correct its malpositioning. During the CPB, hemolysis was also found in the mixed venous blood. Since the oliguria and resultant hyperkalemia persisted after weaning from the CPB, peritoneal dialysis was introduced immediately after the surgery. Her renal function gradually recovered postoperatively, and she was finally weaned from the peritoneal dialysis on the 13 th postoperative day. Although the ministernotomy has been proposed to be a safe approach for most of cardiac surgeries, it appears to increase the risk for arterial cannula malposition as compared to the standard full-length sternotomy in small pediatric patients.

本文言語英語
ページ(範囲)264-269
ページ数6
ジャーナルJapanese Journal of Anesthesiology
51
3
出版ステータス出版済み - 4月 22 2002

!!!All Science Journal Classification (ASJC) codes

  • 麻酔学および疼痛医療

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