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J Cardiothorac Vasc Anesth. 2004 Apr;18(2):152-5.

The value of end-tidal carbon dioxide monitoring during systemic-to-pulmonary artery shunt insertion in cyanotic children.

Author information

1
Department of Anaesthesiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. ntugrul@isbank.net.tr

Abstract

OBJECTIVE:

To investigate the relationship between end-tidal carbon dioxide levels and augmentation of pulmonary blood flow achieved by insertion of systemic-pulmonary shunts.

DESIGN:

Prospective clinical study.

SETTINGS:

University hospital.

PARTICIPANTS:

Nineteen cyanotic children with tetralogy of Fallot.

INTERVENTIONS:

Modified Blalock-Taussig shunt operations were performed on the left side in 14 patients and on the right side in 5 patients.

MEASUREMENTS AND MAIN RESULTS:

End-tidal carbon dioxide tension was recorded, and an arterial blood gas sample was obtained simultaneously after thoracotomy (T0) and after completion of systemic-pulmonary shunt (T1). End-tidal carbon dioxide tension was significantly higher ( p < 0.01), and arterial to end-tidal carbon dioxide tension difference was significantly lower (p < 0.01) at T1 when compared with T0. The increase in end-tidal carbon dioxide showed a statistically significant correlation with the response of arterial oxygen saturation (r = 0.61, p < 0.01). The fall in arterial to end-tidal carbon dioxide tension difference correlated inversely with the change of oxygen saturation (r = -0.81, p < 0.0001).

CONCLUSION:

It is concluded that end-tidal carbon dioxide tension alterations offer an alternative intraoperative tool to monitor pulmonary blood flow during modified Blalock-Taussig shunt procedures.

PMID:
15073703
DOI:
10.1053/j.jvca.2004.01.019
[Indexed for MEDLINE]

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