Researchers at The Children's Hospital of Philadelphia used desflurane, an anesthesia gas, on piglets that underwent a low-flow type of cardiopulmonary bypass at one week of age. The animals that received desflurane were better able to walk and feed, and had less injury to brain tissue, compared to piglets that received liquid anesthesia drugs, a combination of fentanyl and droperidol.
Animals in the desflurane group also showed fewer abnormal heart rhythms during cardiopulmonary bypass, suggesting that the drug may protect heart function as well.
"This study adds to growing evidence that this type of anesthetic protects the brain and nervous system during heart surgery," said Andreas W. Loepke, M.D., Ph.D., a pediatric anesthesiologist at The Children's Hospital of Philadelphia, and lead author of the study published in the December issue of Anesthesiology.
As survival rates have increased for infant heart surgeries, physicians have been able to turn more attention to improving quality of life in survivors. The very techniques that make open heart surgery possible also may contribute to neurological complications. Cardiopulmonary bypass (CPB) reroutes a patient's blood through a heart-lung machine while surgeons repair complex heart defects. During low-flow CPB, blood flow to the brain is reduced to 10 percent of normal, as opposed to deep hypothermic circulatory arrest (DHCA), in which blood flow is completely stopped.
Even though low-flow CPB seems to show some advantages over DHCA in neurological outcomes, following either procedure, children may suffer decreased levels of intelligence and reduced motor and language skills, compared to children who did not
Contact: John Ascenzi
Children's Hospital of Philadelphia