Assessment of Microvascular Circulation in the Pediatric Cardiac Surgery Patient

What this Trial Is About

Pediatric patients undergoing cardiac surgery, particularly those with ventricular septal defect or tetrology of Fallot, experience significant physiological changes during surgery and cardiopulmonary bypass (CPB). Traditional monitoring focuses on large blood vessels, but this may not reflect the true state of smaller vessels. Researchers are evaluating a handheld device called the Cytocam incident dark-field (IDF) microcirculatory camera, which provides real-time video and data of the microvascular circulation in these patients. This observational study involves using the Cytocam device to monitor microvascular blood flow at specific times: after intubation in the operating room, 10 minutes after CPB starts, after the cross clamp is placed, hourly during CPB, after CPB ends, and every 4 hours during the first 48 hours in the intensive care unit. The study includes patients with cyanotic physiology related to tetrology of Fallot and those with acyanotic lesions undergoing ventricular septal defect repair. Participants will be monitored continuously using the Cytocam device during the surgical and recovery periods. Researchers will assess measures such as capillary density, microcirculatory flow index, tissue perfusion surrogates, and signs of acute kidney injury. Secondary outcomes include ventilator duration and adverse events. The study will follow patients for the first 48 hours after surgery to gather these data and understand microvascular changes during and after cardiac surgery.

Assessment of Microvascular Circulation in the Pediatric Cardiac Surgery Patient