Milky White Supernatant in the Cardiopulmonary Bypass Circuit in Severe Hypertriglyceridemia During Pediatric Cardiac Surgery: A Case Report.

We present a case of severe hypertriglyceridemia (HTG) in a 21-month old female undergoing cardiac surgery for a ventricular septal defect and subaortic membrane excision. During the operation, a milky white supernatant was observed in the cardiopulmonary bypass circuit, prompting immediate lipid profile testing that revealed elevated triglycerides. The management involved maintaining anticoagulation with heparin dose-response testing and ensuring oxygenator function by measuring blood gas analysis, lactate, and arterial line pressure. The child recovered without complications. This case highlights the critical need for prompt identification and management of HTG in pediatric cardiac surgery to mitigate risks and ensure successful outcomes.