The Journal of Thoracic and Cardiovascular Surgery, Vol 71, 410-414, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Cardiac output in infants and children after open-heart surgery
NJ Truccone, HM Spotnitz, WM Gersony, R Dell, FO Bowman Jr and JR Malm
Green dye measurements of cardiac index (in liters per minute per square
meter) were compared in 32 infants and 58 children, 6 and 24 hours after
normothermic cardiopulmonary bypass. Cardiac index was significantly lower
in infants under one year of age, as compared to older infants and
children. This parameter was also lower in patients with total anomalous
pulmonary venous drainage, truncus arteriosus, and tetralogy of Fallot.
Five infants who died had 6-hour cardiac index determinations of 2.0
L./min./sq. M. Only 2 of 27 survivors had cardiac indices below this level.
Simultaneously recorded heart rate and central venous pressure did not
correlate with cardiac index. Systolic blood pressure was significantly
lower in infants in whom the cardiac index was less then 2.0 L./min./sq. M.
(p less than 0.01). However, in individual situations, determination of
systemic blood pressure lacked specificity in predicting outcome.
Measurements of cardiac index are helpful in the management of infants and
children following intracardiac repair by (1) assessing the hemodynamic
status, (2) providing a useful indication of the cardiocirculatory effects
of therapeutic interventions, and (3) predicting outcome.
