Research On Injurious Factors And Risk Factors From Cardiopulmonary Bypass In Open Heart Surgery To Nervous System Of Children With Congenital Heart Disease

Objective:To observe the relationship between hematocrit(HCT),arterial oxygen (PaO₂),arterial partial pressure of carbon dioxide(PaCO₂),CPB time and plasma NSE & S-100βlevels in the process of cardiopulmonary bypass(CPB) in open heart surgery.Methods:Choose 40 children with congenital heart disease in Cardiac Surgery Department of Wu Jing Zong Dui Hospital of Guangdong Province from January to April,take their blood samples to measure HCT,PaO₂ and PaCO₂ before,during and after CPB,and simultaneously separate the plasma which should be stored in fridge with a temperature of-70°.At the same time 30 children in the same hospital will be chosen for comparison.ELLSA will be adopted to quantitatively measure the NSE and S-100βlevels of both groups.Results:â‘ The differences of plasma NSE and S-100βof pre-CPB and control groups are not significant(P＞0.05);â‘¡The differences in plasma NSE and S-100βprotein during and after CPB of the children in both the fight to left and left to right shunt groups are of no significance(P＜0.05);â‘¢When CPB starts,plasma NSE keeps surging as time goes by,from(8.28±17.01)μg/L to(38.84±23.80)μg/L,and S-100βalso increases from(3.11±2.74)μg/L to(9.37±6.24)μg/L.The differences are significant(P＜0.05);â‘£Such three factors as CPB time,HCT and PaCO₂ have close relations with plasma NSE and S-100βlevel(P＜0.10);⑤The OR of Pa(CO₂)＜29 mmHg was 6.93(OR95%CI= 1.53-31.38);â‘¥The OR of CPB temperature＞26℃was 6.0(OR95%CI=1.08-33.27);⑦The OR of aortic clamping time＞50minutes was 5.67(OR95%CI= 1.17-17.37);⑧The OR of CPB time＞78minutes was 4.50(OR95%CI=1.17-17.37);⑨The OR of HCT＜0.25 was 10.23(OR95%CI=1.12-93.34).Conclusions:According to the blood gas analysis,reduction of CPB time and regulation of HCT and partial pressure of carbon dioxide within a normal scale can reduce central nervous system injury complications.