title: Usefulness of central venous oxygen saturation monitoring during bidirectional Glenn shunt.
abstract: A PediaSat™ oximetry catheter (PediaSat: Edwards Lifesciences Co., Ltd., Irvine, CA, U. S. A.), which facilitates continuous measurement of central venous oxygen saturation (ScvO2), may be useful for surgery for pediatric congenital heart disease. We used PediaSat during a bidirectional Glenn shunt. The patient was a 13-month-old boy. Under a diagnosis of left single ventricle (pulmonary atresia, right ventricular hypoplasia, atrial septal defect) and residual left aortic arch/left superior vena cava, a modified right Blalock-Taussig shunt was performed. Cyanosis deteriorated, so a bidirectional Glenn shunt was scheduled. After anesthesia induction, a 4.5 Fr double-lumen (8 cm) PediaSat was inserted through the right internal jugular vein for continuous ScvO2 monitoring. Furthermore, the probe of a near-infrared, mixed blood oxygen saturation-measuring monitor was attached to the forehead for continuous monitoring of the regional brain tissue mixed blood oxygen saturation (rSO2) (INVOS™ 5100C, Covidien; Boulder, CO, U. S. A.). Blockage of the right pulmonary artery and right superior vena cava decreased the oxygen saturation, ScvO2, and rSO2, but increased the central venous pressure. Although changes in ScvO2 were parallel to those in rSO2, the former showed more marked changes. A combination of ScvO2 and rSO2 for monitoring during Glenn shunt may be safer.
authors.affiliation: Department of Anesthesiology, Tokushima University Hospital.
authors.forename: Nami
authors.initials: N
authors.lastname: Kakuta
authors.forename: Shinji
authors.initials: S
authors.lastname: Kawahito
authors.forename: Naoji
authors.initials: N
authors.lastname: Mita
authors.forename: Noriko
authors.initials: N
authors.lastname: Kambe
authors.forename: Asuka
authors.initials: A
authors.lastname: Kasai
authors.forename: Narutomo
authors.initials: N
authors.lastname: Wakamatsu
authors.forename: Toshiko
authors.initials: T
authors.lastname: Katayama
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Soga
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Tada
authors.forename: Takashi
authors.initials: T
authors.lastname: Kitaichi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kitagawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kitahata
mesh_terms: D001785:Blood Gas Monitoring, Transcutaneous; D002405:Catheterization, Central Venous; D018729:Fontan Procedure / Q000295:instrumentation / Q000379:methods*; D006330:Heart Defects, Congenital / Q000097:blood* / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods; D010092:Oximetry / Q000295:instrumentation / Q000379:methods*