Goal Directed Hemodynamic Management of Acute Heart Failure After Cardiac Surgery in Children

Goal Directed Hemodynamic Management of Acute Heart Failure After Cardiac Surgery in Children: a Prospective Randomised Trial

Goal directed therapy (GDT) utilises various monitoring techniques to assess cardiovascular performance and allows for timely interventions based on predetermined algorithms. The aim of this prospective randomised study is to evaluate the effect of GDT on major complications in children undergoing radical correction of congenital heart defects, complicated by acute heart failure. Goal directed therapy will be implemented with the aid of transpulmonary thermodilution and based on predetermined algorithms.

Inclusion Criteria:

• informed written consent signed by legal representative (parent or guardian)
• radical correction of congenital heart defect(s)
• use of cardiopulmonary bypass
• vasoactive-inotropic Score of 10 or greater during first 24 hours after surgery.

Exclusion Criteria:

• confirmed intranatal infection;
• gestational age < 37 weeks;
• inotropic support prior to surgery;
• acute renal or hepatic failure prior to surgery;
• participation in conflicting randomised controlled studies.