title: Transpulmonary thermodilution in a pediatric patient with an intracardiac left-to-right shunt.
abstract: Monitoring of cardiac output (CO) in the perioperative period and in seriously ill pediatric patients is of major importance for medical management. Hemodynamic monitoring, using transpulmonary thermodilution (TPTD) via a single thermal indicator injection, allows for measurements of CO, volumetric variables and extravascular lung water (EVLW). We describe and explain the influence of a left-to-right shunt on TPTD curve characteristics and EVLW measurements in a young child undergoing a surgical atrial septal defect repair. We suggest that these specific changes in the TPTD curve and the overestimation of EVLW detected by current device, in absence of gas exchange abnormalities, could be indicators of existing circulatory shunts in pediatric patients.
authors.affiliation: Hospices Civils de Lyon, Groupement Hospitalier Est, Department of Anesthesiology and Intensive Care, Louis Pradel Hospital and Claude Bernard Lyon 1 University, Lyon, France. kellergeoffray@hotmail.fr
authors.forename: Geoffray
authors.initials: G
authors.lastname: Keller
authors.forename: Olivier
authors.initials: O
authors.lastname: Desebbe
authors.forename: Roland
authors.initials: R
authors.lastname: Henaine
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Lehot
mesh_terms: D002302:Cardiac Output / Q000502:physiology*; D015633:Extravascular Lung Water; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D007201:Indicator Dilution Techniques; D007223:Infant; D016343:Monitoring, Intraoperative; D010372:Pediatrics / Q000379:methods; D013815:Thermodilution / Q000295:instrumentation* / Q000379:methods