Continuous SvO2 measurement in infants undergoing congenital heart surgery--first clinical experiences with a new fiberoptic probe.
BACKGROUND
SvO2-guided therapy, using fiberoptic oximetric catheters can help to improve the outcome after complex congenital heart surgery especially in infants undergoing the Stage 1-Norwood-Procedure. So far, fiberoptic catheters have to be placed transthoracically by the surgeon into the vena cava or the pulmonary artery putting the infant at an additional risk of bleeding at the time of catheter removal.


METHODS
We used a new percutaneously applicable fiberoptic probe for continuous monitoring of central venous saturation in three infants undergoing modifications of the Stage 1-Norwood-Procedure (reconstruction of the aortic arch), two in combination with a bidirectional cavopulmonary connection (Glenn shunt), the third with reconstruction of the pulmonary arteries (biventricular repair). The approved clinical monitoring system consisted of a small (2 F) fiberoptic probe and a bed-side-monitor. The probe was inserted via the routine central venous access for such a case.


RESULTS
Continuous SvO2 measurement is feasible in infants using the CeVOX system in combination with routine central venous access, and the advantages of continuous monitoring are discussed.


CONCLUSIONS
We believe that compared with transthoracically inserted oximetric catheter, the presented percutaneous technique avoids additional risks at the time of catheter removal (i.e. bleeding) and has become part of our standard management.
Müller
Matthias
M
Department of Anaesthesiology, Intensive Care Medicine, Pain Therapy, University Hospital Giessen and Marburg, Giessen, Germany. matthias.f.mueller@chiru.med.uni-giessen.de
Löhr
Tobias
T
Scholz
Stefan
S
Thul
Josef
J
Akintürk
Hakan
H
Hempelmann
Gunter
G
D002315:Cardiopulmonary Bypass / Q000379:methods; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D005240:Feasibility Studies; D005336:Fiber Optic Technology / Q000295:instrumentation* / Q000379:methods; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D016343:Monitoring, Intraoperative / Q000379:methods*; D010092:Oximetry / Q000009:adverse effects / Q000295:instrumentation*; D010100:Oxygen / Q000097:blood*; D013997:Time Factors
D010100:Oxygen