[Disorders of hemodynamics and their correction in children with nonhepatic portal hypertension during the course of surgical treatment].

Twenty children with the extrahepatic portal hypertension syndrome were examined; echo- and doppler-cardiography were employed to assess the central hemodynamic status before and after mesenterial-caval H-shunting, making use of a vascular insert from the internal jugular vein. The status of the circulatory system varied in the patients prior to surgery, and a risk group was distinguished with the maximal deviations of the hemodynamic parameters from the age-specific norms. 70% of the patients developed within 3 h after surgery pulmonary hypertension and right-ventricular dysfunction in the presence of a drastic rise of venous reflux to the right heart. Later an attempt was made at correction of the circulatory disorders by dopamine infusion at the rate of 3-6 micrograms/(kg.min) (19 patients). The authors emphasize that directly after shunting inotropic dopamine maintenance is necessary to prevent the development of hemodynamic disorders.