title: Assessment of splanchnic perfusion with gastric tonometry in the immediate postoperative period of cardiac surgery in children.
abstract: OBJECTIVE - A prospective, nonrandomized clinical study to assess splanchnic perfusion based on intramucosal pH in the postoperative period of cardiac surgery and to check the evolution of patients during hospitalization. METHODS - We studied 10 children, during the immediate postoperative period after elective cardiac surgery. Sequential intramucosal pH measurements were taken, without dobutamine (T0) and with 5mcg/kg/min (T1) and 10 (T2) mcg/kg/min. In the pediatric intensive care unit, intramucosal pH measurements were made on admission and 4, 8, 12, and 24 hours thereafter. RESULTS - The patients had an increase in intramucosal pH values with dobutamine 10mcg/kg/min [7.19+/- 0.09 (T0), 7.16+/-0.13(T1), and 7.32+/-0.16(T2)], (p=0.103). During the hospitalization period, the intramucosal pH values were the following: 7.20+/-0.13 (upon admission), 7.27+/-0.16 (after 4 hours), 7.26+/-0.07 (after 8 hours), 7.32+/-0.12 (after 12 hours), and 7.38+/-0.08 (after 24 hours), (p=0.045). No deaths occurred, and none of the patients developed multiple organ and systems dysfunction. CONCLUSION - An increase in and normalization of intramucosal pH was observed after dobutamine use. Measurement of intramucosal pH is a type of monitoring that is easy to perform and free of complications in children during the postoperative period of cardiac surgery.
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, 03080-050, Brazil. acarloscc@cardiol.br
authors.forename: R L
authors.initials: RL
authors.lastname: de Souza
authors.forename: W B
authors.initials: WB
authors.lastname: de Carvalho
authors.forename: M A
authors.initials: MA
authors.lastname: Maluf
authors.forename: A C
authors.initials: AC
authors.lastname: Carvalho
mesh_terms: D002316:Cardiotonic Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D004280:Dobutamine / Q000494:pharmacology*; D005753:Gastric Mucosa; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D008365:Manometry; D011184:Postoperative Period; D011446:Prospective Studies; D013152:Splanchnic Circulation / Q000187:drug effects*
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine