tcPO2 in pediatric cardiology: application during balloon septostomy, tolazoline administration, and in children with right-to-left shunt.
In pediatric cardiology tcPO2 is useful in monitoring cyanotic children given high-risk therapy such as balloon septostomy or drugs with controversial effects such as tolazoline in persistent fetal circulation. tcPO2 during administration of 100% oxygen enables a rapid, noninvasive differentiation between cyanosis due to intracardiac right-to-left shunt and that due to low cardiac output or pulmonary ventilation or diffusion difficulty. The size of the right-to-left shunt can be roughly estimated from the highest value of tcPO2, this estimation being influenced by anemia, hypothermia, and acidosis, among other factors. A trend of the tcPO2 rise is evident 90 seconds after the beginning of oxygen breathing. If tcPO2 does not rise at least 40 mm Hg over the initial value, a significant right-to-left shunt must be suspected. Interpretation of tcPO2 rise is difficult in dynamic right-to-left shunt, changing with oxygen breathing.
D001784:Blood Gas Analysis; D006328:Cardiac Catheterization; D003490:Cyanosis / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006343:Heart Septal Defects / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D010100:Oxygen / Q000097:blood*; D010313:Partial Pressure; D010547:Persistent Fetal Circulation Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D012119:Respiration; D012867:Skin / Q000098:blood supply; D014043:Tolazoline / Q000627:therapeutic use*
D014043:Tolazoline; D010100:Oxygen