Microcirculatory Changes in Pediatric Patients During Congenital Heart Defect Corrective Surgery

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Microcirculation Research

Background:

• Congenital heart defects (CHDs) necessitate complex surgical interventions.
• Understanding intraoperative microcirculatory changes is crucial for pediatric cardiac surgery outcomes.
• Sublingual microcirculation offers a window into systemic hemodynamic status.

Purpose of the Study:

• To evaluate sublingual microcirculation changes in pediatric patients during CHD surgery.
• To correlate microcirculatory parameters with clinical and analytical variables.
• To assess the impact of cardiopulmonary bypass on microvascular function.

Main Methods:

• Prospective, observational, single-center study.
• Inclusion of 24 pediatric patients undergoing CHD surgery.
• Assessment of sublingual microcirculation, clinical, and analytical parameters preoperatively, intraoperatively, and postoperatively.

Main Results:

• Microcirculatory parameters significantly worsened during cardiopulmonary bypass (CPB).
• Parameters returned to baseline post-surgery (p ≤ 0.001).
• Intraoperative body temperature correlated with microcirculation (e.g., perfused small vessel density, p = 0.014).
• Cyanotic patients showed altered baseline and intraoperative microcirculation (e.g., higher density, lower flow index).

Conclusions:

• Pediatric CHD surgery, particularly CPB, transiently impairs sublingual microcirculation.
• Microvascular density and flow decrease, while heterogeneity increases during CPB.
• These microcirculatory disturbances are reversible post-surgery.