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Monitoring of pacemaker induced changes in cardiac output with inspired to endtidal oxygen difference in paediatric cardiac surgery patients
Author(s) -
Bengtsson Jan,
Edberg Karl Erik,
Nilsson Boris,
Bengtson Jan Peter
Publication year - 2001
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.2001.00642.x
Subject(s) - medicine , heart rate , anesthesia , cardiology , blood pressure
Methods: Fourteen children aged 4–15 months were studied after corrective cardiac surgery. Heart rate was increased by 20% with an external pacemaker. Cardiac output (CO) was measured with thermodilution. Oxygen saturation was measured in systemic artery (SaO 2 ), central vein (ScvcO 2 ) and pulmonary artery (SvO 2 ). Inspiratory to endtidal oxygen difference (F I ‐ ET O 2 ) was measured using a paramagnetic technique. SvO 2 was measured continuously using a spectrophotometric technique. Results: CO increased in three patients and decreased in 11 patients during pacing. Regression between ΔCO and Δ(1/Sa‐vO 2 ), Δ(F I ‐ ET O 2 /Sa‐vO 2 ), Δ(F I ‐ ET O 2 /Sa‐cvcO 2 ) showed r =0.70, r =0.76 and r =0.75, respectively. ΔCO exceeded 10% in 17 of 26 interventions. Changes in F I ‐ ET O 2 of equal direction as changes in CO occurred in 12 of these 17 interventions. Conclusions: Estimations of CO changes, based on SvO 2 , can be enhanced if changes in F I ‐ ET O 2 are also measured. ScvcO 2 instead of SvO 2 gives equivalent results. Sudden changes in F I ‐ ET O 2 after pacemaker initiation or termination can predict the direction of CO changes.