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Effect of the Duration of Cardiopulmonary Bypass on Oxygenation Predicted by Measuring Thoracic Fluid Content Using Electrical Cardiometry in Infants Undergoing Closure of Ventricular Septal Defect:A Prospective Observational Study.

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Τίτλος: Effect of the Duration of Cardiopulmonary Bypass on Oxygenation Predicted by Measuring Thoracic Fluid Content Using Electrical Cardiometry in Infants Undergoing Closure of Ventricular Septal Defect:A Prospective Observational Study.
Συγγραφείς: Laguduva AH; Department of Cardiothoracic and Vascular Anesthesia, All India Institute of Medical Sciences, New Delhi, India. Electronic address: aakshaylh@gmail.com., Gharde P; Department of Cardiothoracic and Vascular Anesthesia, All India Institute of Medical Sciences, New Delhi, India., Chauhan S; Department of Cardiothoracic and Vascular Anesthesia, All India Institute of Medical Sciences, New Delhi, India., Ramakrishnan L; Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India., Prakash M; Department of Cardiothoracic and Vascular Anesthesia, All India Institute of Medical Sciences, New Delhi, India., Arasu M; Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India., Anandan V; Department of Cardiothoracic and Vascular Anesthesia, All India Institute of Medical Sciences, New Delhi, India., S R; Department of Cardiothoracic and Vascular Anesthesia, All India Institute of Medical Sciences, New Delhi, India.
Πηγή: Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2026 Oct; Vol. 40 (10), pp. 3277-3286. Date of Electronic Publication: 2026 Jun 11.
Τύπος έκδοσης: Journal Article; Observational Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 9110208 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8422 (Electronic) Linking ISSN: 10530770 NLM ISO Abbreviation: J Cardiothorac Vasc Anesth Subsets: MEDLINE
Imprint Name(s): Original Publication: Philadelphia, PA : W.B. Saunders, c1991-
Ιατρικοί όροι (MeSH): Heart Septal Defects, Ventricular*/surgery , Heart Septal Defects, Ventricular*/diagnosis , Cardiopulmonary Bypass*/methods , Cardiopulmonary Bypass*/adverse effects , Cardiopulmonary Bypass*/trends , Oxygen*/metabolism , Oxygen*/blood , Body Fluids*/metabolism, Humans ; Prospective Studies ; Female ; Male ; Infant ; Time Factors ; Predictive Value of Tests
Περίληψη: Objective: To evaluate the relationship between cardiopulmonary bypass (CPB) duration, change in thoracic fluid content (ΔTFC) measured using electrical cardiometry, and postoperative oxygenation in infants undergoing ventricular septal defect (VSD) closure.
Design: Prospective observational study.
Setting: Single tertiary academic cardiac center.
Participants: Thirty infants (1-12 months) undergoing elective VSD closure with CPB.
Interventions: Thoracic fluid content was measured using an electrical cardiometry (ICON monitor) before CPB and after separation from CPB. Arterial blood gases and ventilatory parameters were recorded at corresponding time points.
Measurements and Main Results: CPB duration was positively correlated with ΔTFC (r = 0.50, p = 0.0045) and negatively correlated with a change in PaO2/FIO2 ratio (ΔP/F; r = -0.60, p = 0.0005) and dynamic compliance (r = -0.48, p = 0.007). Receiver operating characteristic analysis demonstrated excellent discrimination for postoperative oxygenation impairment (P/F <300) for both ΔTFC (area under the curve [AUC] = 0.91) and CPB duration (AUC 0.92). The optimal thresholds obtained were ΔTFC ≥13 kΩ-1 and CPB ≥84 minutes. In the multivariate linear regression adjusted for IL-6, prime volume/kg, transfusion/kg, and conventional ultrafiltration, ΔTFC independently predicted the postoperative P/F ratio (β = -5.68; p = 0.013), whereas CPB duration was not independently associated.
Conclusion: Prolonged CPB is associated with greater thoracic fluid accumulation and impaired oxygenation in infants undergoing VSD closure. However, the relationship between CPB duration, ΔTFC, and pulmonary dysfunction appeared multifactorial and was influenced by perioperative inflammatory and fluid-related variables. Perioperative ΔTFC monitoring may provide a useful noninvasive adjunct for assessing postoperative pulmonary status after pediatric cardiac surgery.
(Copyright © 2026 Elsevier Inc. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Contributed Indexing: Keywords: CPB; ICON; electrical cardiometry; oxygenation; thoracic fluid content; ventricular septal defect
Substance Nomenclature: S88TT14065 (Oxygen)
Entry Date(s): Date Created: 20260704 Date Completed: 20260916 Latest Revision: 20261004
Update Code: 20261005
DOI: 10.1053/j.jvca.2026.06.016
PMID: 42401502
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1532-8422
DOI:10.1053/j.jvca.2026.06.016