Left-to-right shunt assessed by thermodilution during surgery for congenital heart disease.
In nine children with congenital heart defects, left-to-right shunting was assessed during open-heart surgery by injecting cold 5% glucose solution through a left atrial line and detecting temperature change with a pulmonary arterial thermistor. The shunt was quantified by recording the temperature after injecting the same amount of cold glucose solution also through a central venous line. Oximetric determination of the left-to-right shunt was used as a reference. The result was expressed as shunt flow divided by pulmonary blood flow (Qshunt/Qp). The regression equation then obtained was Qshunt/Qp by thermodilution = 0.05 + 0.87 x Qshunt/Qp by oximetry. The residual standard deviation around the line of regression was 0.03. The thermodilution technique can be used for rapid assessment of the presence and magnitude of left-to-right shunting, provided that there is opportunity for the indicator to mix adequately in the main blood stream before shunting occurs.
Department of Thoracic Surgery, University Hospital, Lund, Sweden.
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Jöji
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Werner
D001794:Blood Pressure; D002675:Child, Preschool; D005947:Glucose / Q000008:administration & dosage; D006330:Heart Defects, Congenital / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D010092:Oximetry; D013815:Thermodilution / Q000379:methods
D005947:Glucose