title: Gastric tonometer monitoring in infants undergoing repair of coarctation of the aorta.
abstract: 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.
authors.affiliation: Department of Anesthesiology, Istanbul Memorial Hospital, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Soybir
authors.forename: S
authors.initials: S
authors.lastname: Tekin
authors.forename: O
authors.initials: O
authors.lastname: Koner
authors.forename: S
authors.initials: S
authors.lastname: Arat
authors.forename: K
authors.initials: K
authors.lastname: Karaoglu
authors.forename: T
authors.initials: T
authors.lastname: Sarioglu
mesh_terms: 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