Pediatric Cardiopulmonary Bypass and Hypothermic Circulatory Arrest

The routine use of cardiopulmonary bypass (CPB) began in the 1950s with the successful development of reliable artificial oxygenation devices and the heart-lung machine. Prior to its development, intracardiac repair of even simple congenital heart defects was fraught with peril, and complex repairs were considered nearly impossible. Today, due to major medical advances, pediatric CPB is used safely all over the world, allowing precise repair of most congenital heart defects. This chapter reviews conduct of CPB, blood flow and oxygen delivery through the CPB circuit, weaning from CPB, differences between adult and pediatric CPB, and the technique of deep hypothermic circulatory arrest.