title: The value of end-tidal carbon dioxide monitoring during systemic-to-pulmonary artery shunt insertion in cyanotic children.
abstract: 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.
authors.affiliation: Department of Anaesthesiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. ntugrul@isbank.net.tr
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tugrul
authors.forename: Emre
authors.initials: E
authors.lastname: Camci
authors.forename: Zerrin
authors.initials: Z
authors.lastname: Sungur
authors.forename: Kamil
authors.initials: K
authors.lastname: Pembeci
mesh_terms: 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
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen