Venoarterial PCO2 difference: a marker of postoperative cardiac output in children with congenital heart disease

Muhammad Furqan; Fahad Hashmat; Munir Amanullah; Mansoor Khan; Hina K Durani; Anwar-ul-Haque

doi:10.2009/JCPSP.640643

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Journal article

Venoarterial PCO2 difference: a marker of postoperative cardiac output in children with congenital heart disease

Muhammad Furqan, Fahad Hashmat, Munir Amanullah, Mansoor Khan, Hina K Durani and Anwar-ul-Haque

Journal of the College of Physicians and Surgeons--Pakistan, Vol.19(10), pp.640-643

10/2009

DOI: 10.2009/JCPSP.640643

PMID: 19811716

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Abstract

To determine the relationship between venoarterial carbon dioxide gradient (DeltapCO2) and central venous oxygen saturation (ScvO2) in children after cardiac surgery. A cohort study. The Paediatric cardiac intensive care unit of the Aga Khan University Hospital, Karachi, from June 2006 to May 2007. All children admitted in the paediatric cardiac intensive care after complete repair of congenital heart defect using cardiopulmonary bypass were included in the study. Simultaneous arterial and central venous blood gas samples were obtained from a catheter placed in the artery (either radial or femoral) and superior vena cava respectively. Linear regression analysis was performed between ScvO2 and DeltapCO2. Fifty seven children aged from 5 days to 14 years were included and 272-paired simultaneous arterial and central venous samples were analyzed. Mean venous pCO2 was 47.82+/-9.03 mmHg and mean arterial pCO2 was 40.50+/-9.06 mmHg. One hundred seventy four samples had ScvO2 > 70% with mean DeltapCO2 of 5.44+/-2.55 mmHg and 98 samples had ScvO2 < 70% with mean DeltapCO2 of 9.07+/-3.90 mmHg. With ScvO2 < 70%, 77 samples had DeltapCO2 of > 6 mmHg while only 21 samples had DeltapCO2 of < 6 mmHg (p < 0.001). On the contrary with ScvO2 > 70%, 71 samples had DeltapCO2 of > 6 mmHg and 103 samples had DeltapCO2 of < 6 mmHg. Coefficient of correlation (R2) between 0.340 was ScvO2 and DeltapCO2. Elevated DeltapCO2 is practical and can be utilized as a useful adjunct to low ScvO2 in the assessment of low cardiac output syndrome in children after cardiac surgery.

Heart Defects, Congenital - surgery

Humans

Cardiac Output

Postoperative Complications - blood

Child, Preschool

Infant

Male

Vena Cava, Superior

Female

Cardiac Output, Low - blood

Retrospective Studies

Child

Infant, Newborn

Heart Defects, Congenital - blood

Risk Factors

Blood Gas Analysis

Oxygen Consumption

Postoperative Period

Carbon Dioxide - blood

Oxygen - blood

Postoperative Complications - diagnosis

Intensive Care Units, Pediatric - statistics & numerical data

Adolescent

Biomarkers

Cardiac Output, Low - diagnosis

Heart Defects, Congenital - physiopathology

Cohort Studies

Details

Title: Subtitle: Venoarterial PCO2 difference: a marker of postoperative cardiac output in children with congenital heart disease
Creators: Muhammad Furqan - Department of Paediatrics, The Aga Khan University Hospital, Karachi
Fahad Hashmat
Munir Amanullah
Mansoor Khan
Hina K Durani
Anwar-ul-Haque
Resource Type: Journal article
Publication Details: Journal of the College of Physicians and Surgeons--Pakistan, Vol.19(10), pp.640-643
DOI: 10.2009/JCPSP.640643
PMID: 19811716
ISSN: 1022-386X
eISSN: 1681-7168
Language: English
Date published: 10/2009
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
Record Identifier: 9984094558202771

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