SHIMIZU, Naoki

清水, 直樹

[SUMMARY] Bidirectional superior cavopulmonary anastomosis （BCPA） is now widely accepted as palliative surgery for congenital heart diseases such as hypoplastic left heart syndrome. Although hyperventilation is useful for decreasing pulmonary vessel resistance, reducing cerebral blood flow （CBF） may lead to low oxygenation after BCPA. However, Hoskote and Li concluded that moderate hypercapnia, which increases CBF, improved arterial oxygenation, reduced oxygen consumption and arterial lactate levels, thus improving overall oxygen transport in children after BCPA. We report here the use of near infrared spectroscopy（ NIRS） in our pediatric intensive care unit as a routine and useful bedside method of monitoring CBF after BCPA. We found clearly that hypercapnia increased the tissue oxygenation index on NIRS and improved oxygenation after BCPA. This hyperventilation strategy may have life-saving potential for some patients after BCPA, and its use in conjunction with NIRS bedside monitoring should be promoted in Japan.

03035476