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Metabolic alkalosis in children undergoing cardiac surgery

H R Wong1, K R Chundu

  • 1Division of Pediatric Medicine, Children's National Medical Center, Washington, DC.

Critical Care Medicine
|June 1, 1993
PubMed

Insights

Metabolic alkalosis affects over half of children after open-heart surgery, particularly younger patients. Chloride depletion is a key factor, highlighting the need for careful monitoring in pediatric intensive care.

Area of Science:

  • Pediatric critical care medicine
  • Pediatric cardiology
  • Pediatric nephrology

Background:

  • Metabolic alkalosis is a common acid-base disorder in critically ill patients.
  • Understanding its incidence and causes in pediatric cardiac surgery is crucial for patient management.

Purpose of the Study:

  • To determine the frequency of metabolic alkalosis in children following open-heart surgery.
  • To investigate the contributing factors and pathogenesis of this condition in this specific population.

Main Methods:

  • Retrospective chart review of 56 pediatric patients.
  • Analysis conducted in a multidisciplinary, tertiary pediatric intensive care unit.

Main Results:

  • Metabolic alkalosis was observed in 52% of patients.
  • Younger age (<12 months) and lower serum chloride concentrations were significant predictors.
  • Patients with metabolic alkalosis received more furosemide and had longer cardiopulmonary bypass times.

Conclusions:

  • Postoperative metabolic alkalosis is frequent in pediatric open-heart surgery patients.
  • Chloride depletion is a primary driver of metabolic alkalosis.
  • Younger age is a significant risk factor for developing metabolic alkalosis.
Abstract

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