Neuroprotection during pediatric cardiac surgery. RAMI .M. WAHBA, M.D Lecturer of Anesthesia and Intensive care Ain Shams University. Introduction. Concern towards long-term functional neurological morbidities . this review is foccussing on : adverse neurologic outcomes.
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RAMI .M. WAHBA, M.D
Lecturer of Anesthesia and Intensive care
Ain Shams University
the safe period might be 20 to 30 minutes, but this is controversial.
Alternatives to DHCA : intermittent cerebral perfusion,regional cerebral perfusion, and low-flow CPB
-cerebral anaerobic metabolism
-improves brain histology and neurologic outcome when compared with DHCA.
-High-energy phosphate preservation
-Cerebral oxygen metabolism
-Cerebral vascular resistance
-Brain lactate levels.
- more effectively cools the brain.
-The oxygen dissociation curve shifts rightward, increasing oxygen availability.
-There is a more rapid recovery of high-energy phosphates after DHCA.
Compared with a-stat, infants managed with pHstat had lower postoperative morbidity and shorter recovery time to first EEC activity after DHCA.