Pediatric cardiopulmonary bypass circuits: a review of studies conducted at the Penn State Pediatric Cardiac Research Laboratories.

Cardiopulmonary bypass (CPB) circuits are frequently necessary in the repair of congenital heart defects in infants and children. Although advances in technology and operative technique have decreased the mortality associated with cardiac procedures requiring CPB, post-operative neuro-cognitive outcome and the role of the CPB circuit in post-operative morbidity remains a significant concern. There are several factors that have been suggested to play a significant role in general post-operative outcome, including intraoperative inflammatory responses caused by the interaction of blood with circuit component surfaces, selection of appropriate perfusion mode to optimize organ function during CPB, and the introduction of gaseous microemboli into the patient's systemic circulation through circuit manipulations and modifications. These factors are the subject of continuing research at the Penn State Hershey Children's Hospital Pediatric Cardiac Research Laboratories, and this review will focus on the results of studies aimed at identifying circuit elements that affect the delivery of gaseous microemboli to the patient during CPB procedures, the role of anti-factor D monoclonal antibody in reducing systemic inflammation during CPB, and the results of preliminary plasma proteomics studies conducted on infants undergoing CPB.