It is estimated that 80-95% of patients who undergo cardiac surgery during the paediatric period survive into adulthood. This has highlighted the issue of long-term morbidities associated with cardiopulmonary bypass-dependant cardiac surgery such as neurological dysfunction which affects 2-25% of patients postoperatively. Several perioperative factors increase the risk of neurological dysfunction, including deep hypothermic circulatory arrest (DHCA) which is necessary for repair/palliation of certain complex lesions. Several perioperative neuromonitoring modalities are available to detect dangerous events and guide interventions to reduce risk.
A survey of 33 questions on temperature management, DHCA and neuromonitoring during CPB was sent to perfusionists at all 12 paediatric centres across the UK and Ireland. 100% of centres responded. A great deal of heterogeneity across centres was identified in temperature definitions. 92% of centres use a nasopharyngeal probe and 8% use rectal and bladder probes.100% of centres use DHCA, totalling 9.7% of all annual paediatric bypass cases. 100% of centres use temperature to initiate DHCA, from 18-24°C or variable. 92% of centres use near-infrared spectroscopy for neuromonitoring.
This is the first survey to be done across the paediatric centres in the UK and Ireland looking specifically at temperature management, DHCA and neuromonitoring. There were similarities in this survey with similar international surveys, specifically in temperature definitions which could suggest different average bypass times for similar surgeries across countries and centres.
Shannon is a trainee perfusionist at Birmingham Children’s Hospital. She graduated from the University of Plymouth in 2019 with an BSc in Biomedical Science before achieving a trainee post and starting the MSc in Perfusion Science at the University of Bristol later that year. During her training she has particularly enjoyed the variation and intensity of working in paediatrics, and she is looking forward to becoming a well-rounded clinical perfusionist with a keen interest in research and shared learning between centres. Her dissertation survey highlights her eagerness to learn from other centres, both local and international, to improve patient outcomes.