Management of the Low Cardiac Output Syndrome Following Surgery for Congenital Heart Disease

Title:Management of the Low Cardiac Output Syndrome Following Surgery for Congenital Heart Disease

Volume: 12 Issue: 2

Author(s): Heather K. Chandler and Roxanne Kirsch

Affiliation:

Keywords: Acute kidney injury, heart failure, hemodynamic monitoring, low cardiac output, mechanical circulatory devices, Pediatrics, vasoactive therapies.

Abstract: The purpose of this review is to discuss the management of the low cardiac output syndrome (LCOS) following surgery for congenital heart disease. The LCOS is a well-recognized, frequent post-operative complication with an accepted collection of hemodynamic and physiologic aberrations. Approximately 25% of children experience a decrease in cardiac index of less than 2 L/min/m2 within 6-18 hours after cardiac surgery. Post-operative strategies that may be used to manage patients as risk for or in a state of low cardiac output include the use of hemodynamic monitoring, enabling a timely and accurate assessment of cardiovascular function and tissue oxygenation; optimization of ventricular loading conditions; the judicious use of inotropic agents; an appreciation of and the utilization of positive pressure ventilation for circulatory support; and, in some circumstances, mechanical circulatory support. All interventions and strategies should culminate in improving the relationship between oxygen supply and demand, ensuring adequate tissue oxygenation.

Cite this article as:

K. Chandler Heather and Kirsch Roxanne, Management of the Low Cardiac Output Syndrome Following Surgery for Congenital Heart Disease, Current Cardiology Reviews 2016; 12 (2) . https://dx.doi.org/10.2174/1573403X12666151119164647