Special Issue "Current Issues in Use of Cardiopulmonary Bypass in Infants and Children"

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Cardiology".

Deadline for manuscript submissions: 15 September 2021.

Special Issue Editor

Dr. Massimo A. Padalino
E-Mail Website
Guest Editor
Department of Cardiac Thoracic and Vascular Sciences and Public Health, University of Padova Medical School, 35121 Padova, Italy
Interests: pediatric cardiology; congenital heart disease; neurological outcomes after congenital cardiac surgery and neuroprotective strategies

Special Issue Information

Dear Colleagues,

We wish to explore the current issues of the use of cardiopulmonary bypass in neonates and infants, with special attention to the long-term outcomes. As we know, congenital heart diseases (CHDs) affect nearly 1% of all births per year in the USA (40,000). About 25% of the patients have a critical CHD and need a surgical intervention in the first year of life. Improved surgical techniques and postoperative care in the last few decades have increased survival after surgery for CHD, with an overall estimate of 3% early mortality. Thus, medical community is now oriented towards improving quality of life rather than survival. Neurological complications have emerged as a key issue in the long-term quality of life of children undergoing CHD surgery during infancy. Nearly 50% of children that have undergone CHD surgery in infancy showed a neurocognitive deficit at the beginning of the scholar age (Markowitz et al., Seminars in Cardiothoracic and Vascular Anesthesia 2007; 11: 59–65). Several “suspects” were considered to contribute to this deficit, but none have been found to be prevailing. Preoperative central nervous system (CNS) insults occur from fetal life, especially in CHD with a diminished cerebral flow and brain dysgenesis (i.e., single ventricle physiology), continuing in the early post-natal life with cyanosis, cerebral circulation dysregulation, and hypoxic-ischemic insults. Moreover, the same techniques responsible for enhanced survival in CHD surgery (low-flow cardiopulmonary bypass, CPB, and deep hypothermic cardiac arrest, DHCA) have been suspected to be also responsible for the surgery-associated brain injury, requiring sustained periods of decreased cerebral flow. Finally, in the postoperative period, CPB and DHCA are responsible for an increased vascular resistance combined with a diminished blood flow, resulting in an impaired vasoregulation (Albers et al., Pediatric Research 2010; 68: 1–9). Thanks to technical advancement in cardiopulmonary bypass techniques and neurologic status monitoring (i.e., near-infrared spectroscopy, NIRS), several neuroprotective strategies (such as regional cerebral perfusion, RCP, either antegrade or retrograde) have been developed in the last 20 years to overcome or minimize surgery-related brain injury, but often the neurological outcome seems unchanged (Hirsch et al. Ann. Thorac. Surgery 2012; 94: 1365–1373). Cerebral injury biomarkers seem to be a promising tool to identify brain damage early after surgery and act effectively to prevent further exacerbation of CNS deficit. In addition, preoperative brain imaging can demonstrate an abnormal status that can be the cause of long-term disabilities and, if known, may be better managed during surgery.

Prof. Dr. Massimo A. Padalino
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • congenital heart disease
  • pediatrics
  • brain injury
  • biomarkers
  • neurological development
  • cardiopulmonary bypass

Published Papers

This special issue is now open for submission.
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