Controversies in managing cardiopulmonary bypass in neonates and infants

Since the advent of cardiopulmonary bypass (CPB) in 1953, brisk progress has been made in the development and refinement of CPB techniques to ensure safe, reliable and reproducible systemic organic perfusion in patients undergoing open-heart surgery. As the practice of CPB has evolved over the last few decades, there has been increasing realization that management of CPB in neonates and infants poses specific challenges and needs meticulous attention. As a result of this, different groups have developed a wide variety of protocols. This has made the management of CPB in neonates and infants an area of intense speculation and controversy, some of which are discussed below.