Evaluation of hemodynamics in infants and small babies after open heart surgery.

The study was undertaken to establish typical hemodynamic changes and reliable clinical tests for the evaluation of these in infants after open heart surgery. The cardiac index was measured using the thermodilution technique in 56 infants. The age of the patients varied from 6 to 28 months and body weight from 4 to 15 kg. All studies were done during the first 24 hours after operation. It was shown that in a hemodynamically smooth postoperative course cardiac index exceeds 2.7 l X min-1 X m-2, toe temperature (normal 32 degrees to 34 degrees C) and rectal-skin temperature gradient (normal 2 degrees to 3 degrees C) are normalized within 6 to 9 hours postoperatively. In case of low cardiac output syndrome, the cardiac index was below 2.5 l X min-1 X m-2, toe temperature was lowered to 26 degrees to 28 degrees C and the rectal-skin temperature gradient was 8 degrees to 10 degrees C. Big toe skin temperature correlated well with the magnitude of the cardiac index (r = 0.80; n = 247; p less than 0.001); stroke index (r = 0.70; n = 247; p less than 0.001); systemic vascular resistance (r = 0.64; n = 247; p less than 0.001) and urine output (r = 0.74; n = 247; p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)