Short-term Effects of Cardiopulmonary Bypass Case Series Temperature on Intracardiac Repair for Tetralogy of Fallot: A Retrospective Single Centre Observational Study

Abstract

Introduction: Tetralogy of Fallot (TOF) is a common cyanotic disease and the concept of ideal Cardiopulmonary Bypass (CPB) temperature is still controversial. Aim: To assess the merits and demerits in terms of short term patient outcome of normothermic CPB over hypothermic CPB during intracardiac repair of TOF amongst paediatric patients. Materials and Methods: Among 71 patients of TOF who underwent Intracardiac Repair (ICR) in the Department of Cardiovascular and Thoracic Surgery from 1st January, 2016 to 30th April, 2017, 60 patients were included in our single centre retrospective observational study. Normally distributed variables were expressed by their mean and standard deviation; non normally distributed variables were expressed by their medians and interquartile ranges; categorical variables were expressed as n (%). Statistical software Stata IC version 14, R version 3.2.1 and MedCal were used. All tests were two-tailed with level of significance as <0.05. Results: Normothermic CPB resulted in reduced post-operative Intensive Care Unit (ICU) and hospital stay, lesser incidence of delayed extubation and post-operative Right Ventricular (RV) dysfunction and lesser transfusion requirements of Fresh Frozen Plasma (FFP). (p<0.05). There was no impact of the CPB temperature on renal function, mean blood sugar levels, coagulation parameter and post-operative drain output, postoperative fever, wound infection, arrhythmia or re-exploration. Conclusion: ICR for TOF under normothermic CPB is feasible and results in better post-operative outcomes in terms of duration of ventilation, ICU and hospital stay and RV functions.

Keywords

• congenital heart disease
• hypothermia
• normothermia