Gastric tonometer monitoring in infants undergoing repair of coarctation of the aorta.
OBJECTIVE
To evaluate gastric tonometer monitoring for splanchnic hypoperfusion in infants during surgical intervention for aortic coarctation, especially within aortic cross-clamp periods.


METHODS
A prospective study.


METHODS
Cardiovascular intensive care unit in a university hospital.


METHODS
Fourteen infant patients after elective, uncomplicated repair of coarctation of the aorta.


METHODS
After the anesthesia induction, a 7F tonometry catheter was inserted into the stomach oropharyngeally. Gastric carbon dioxide, arterial blood gases, blood pressure of upper extremities, and hematocrit values were measured in 5 different time intervals. Time periods were as follows: T1 (after the anesthesia induction), T2 (before aortic cross-clamp), T3 (immediately after aortic cross-clamp removal), T4 (40 minutes after aortic cross-clamp removal), and T5 (as the patient reached the intensive care unit). Intramucosal pH was measured by means of the Henderson-Hasselbach equation. The mean values of all parameters were calculated. According to T1 time, T2, T3, T4, and T5 times were compared with Student's t-test.


RESULTS
Mean aortic cross-clamp time was 19.4 +/- 6.6 minutes. Intramucosal pH values of T3 (p < 0.001) and T4 (p < 0.01) were found to be lower than values of T1. The gastric carbon dioxide values of T3 were significantly higher than T1 (p < 0.01), and bicarbonate and arterial pH values of T3 were significantly lower (p < 0.01). There were no significant differences in other parameters over time intervals.


CONCLUSIONS
Splanchnic hypoperfusion exists during aortic cross-clamping in infant aortic coarctation surgery, and the tonometric catheter is considered to be a safe method for monitoring this hypoperfusion.
Soybir
N
N
Department of Anesthesiology, Istanbul Memorial Hospital, Turkey.
Tekin
S
S
Koner
O
O
Arat
S
S
Karaoglu
K
K
Sarioglu
T
T
D001017:Aortic Coarctation / Q000601:surgery*; D001784:Blood Gas Analysis; D003250:Constriction; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007223:Infant; D008297:Male; D008365:Manometry / Q000379:methods*; D016343:Monitoring, Intraoperative / Q000379:methods*; D011446:Prospective Studies; D013152:Splanchnic Circulation / Q000502:physiology; D013270:Stomach / Q000502:physiology*; D014656:Vascular Surgical Procedures