The value of end-tidal carbon dioxide monitoring during systemic-to-pulmonary artery shunt insertion in cyanotic children.
OBJECTIVE
To investigate the relationship between end-tidal carbon dioxide levels and augmentation of pulmonary blood flow achieved by insertion of systemic-pulmonary shunts.


METHODS
Prospective clinical study.


METHODS
University hospital.


METHODS
Nineteen cyanotic children with tetralogy of Fallot.


METHODS
Modified Blalock-Taussig shunt operations were performed on the left side in 14 patients and on the right side in 5 patients.


RESULTS
End-tidal carbon dioxide tension was recorded, and an arterial blood gas sample was obtained simultaneously after thoracotomy (T0) and after completion of systemic-pulmonary shunt (T1). End-tidal carbon dioxide tension was significantly higher ( p < 0.01), and arterial to end-tidal carbon dioxide tension difference was significantly lower (p < 0.01) at T1 when compared with T0. The increase in end-tidal carbon dioxide showed a statistically significant correlation with the response of arterial oxygen saturation (r = 0.61, p < 0.01). The fall in arterial to end-tidal carbon dioxide tension difference correlated inversely with the change of oxygen saturation (r = -0.81, p < 0.0001).


CONCLUSIONS
It is concluded that end-tidal carbon dioxide tension alterations offer an alternative intraoperative tool to monitor pulmonary blood flow during modified Blalock-Taussig shunt procedures.
Tugrul
Mehmet
M
Department of Anaesthesiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. ntugrul@isbank.net.tr
Camci
Emre
E
Sungur
Zerrin
Z
Pembeci
Kamil
K
D001784:Blood Gas Analysis / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002245:Carbon Dioxide / Q000097:blood*; D013504:Cardiovascular Surgical Procedures; D002675:Child, Preschool; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D010100:Oxygen / Q000097:blood; D010166:Palliative Care / Q000379:methods; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000503:physiopathology / Q000601:surgery*; D011652:Pulmonary Circulation / Q000502:physiology; D018709:Statistics, Nonparametric; D013348:Subclavian Artery / Q000601:surgery; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods; D013990:Tidal Volume / Q000502:physiology; D016896:Treatment Outcome
D002245:Carbon Dioxide; D010100:Oxygen