Evaluation On The Hemodynamic Changes After Cardiac Surgery For Congenital Heart Disease In Children

Objective： To make a hemodynamic monitor for the children atfer theoperation of congenital heart disease by application of Ultrasonic CardiacOutput Monitor（USCOM）.Knowing about the change of heart function inthe early postoperative. Evaluating can the venous blood oxygen saturation（ScvO₂）, blood lactic acid （Lac）, heart rate （HR）, mean arterial pressure（MAP）, etc reflect the change of heart function.Methods： Prospective studies： Selecting26children after theoperation of congenital heart disease which were admitted to Children’sHospital of Chongqing medical university between September2011andNovember2011.Geting the cardiac index （CI） in24hours （lh,4h,8hh,24h）after the surgery. And recording Lac, ScvC>2，HR, MAP at the same time.Grouping by the degree of pulmonary hypertension, cardiopulmonarybypass time （CPBT）, age and weight. Statistical methods: Making acomparative study of CI in different moment, describing CI change trendchart and making correlation analysis between CI and ScvC>2, Lac, HR,MAP. Results: All of them discharged smoothly. There were nocomplications associated with USCOM. Overall, CI reached the peak at4h,the lowest point at24h postoperatively. The24CI rose closely to1h CI.CIof the groups: No-mild PH group were higher than severe PH group, and itwas statistically significant difference at8h （p <0.05）. CPBT <60mingroup were higher than CPBT>60min group, and it was statisticallysignificant difference at8h <,24h（p0>.05）.Age12month group werehigher than age<12month group, and it was statistically significantdifference at8h （p <0.05）.There were no statistically significant differencebetween weight<10kg group and weight>10kg group(（p>0.05）. Therewas a significantly positive correlation between ScvO₂and CI （1h: r=0.748, p <0.05;4h: r=0.611, p <0.05;8h: r=0<.680, p0.05;24h: r=0.809, p <0.05）.CI had no statistically significant correlation with Lac, HRand MAP （p <0.05）.Conclusions: As a noninvasive heart discharge blood monitoringmethod, USCOM can reflect the change trend of postoperative children’scardiac function. The children’s cardiac function was lowest at8h atfer thesurgery of ventricular septal defect （VSD）. Moderate-severe PH group,CPBT>60min group, age<12month group were more obvious. ScvC>2canreflect oxygen status of the organization and organs, and reflect the changeof cardiac function real-timely. Lac, HR and MAP can not reflect thechange of heart function.