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Published on: August 19, 2020
Transpulmonary thermodilution in neonates undergoing arterial switch surgery
Andrea Székely1, Tamás Breuer, Erzsébet Sápi
1Department of Anesthesia and Intensive Care, Gottsegen György Hungarian Institute of Cardiology, Haller u. 29, Budapest, 1096, Hungary. szekelya@kardio.hu
Pediatric Cardiology
|November 10, 2010
Summary
Transpulmonary thermodilution (TPTD) effectively measures hemodynamic changes in neonates after arterial switch surgery. This technique aids in assessing cardiac function and guiding therapy using global end-diastolic volume index (GEDI).
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Hemodynamics
Background:
- Global end-diastolic volume index (GEDI) via transpulmonary thermodilution (TPTD) is established for adult preload assessment.
- Neonatal hemodynamic monitoring post-arterial switch surgery requires precise preload evaluation.
Purpose of the Study:
- To investigate hemodynamic alterations in neonates during the postoperative period following arterial switch surgery.
- To evaluate the utility of TPTD in assessing cardiac function in this specific neonatal population.
Main Methods:
- Retrospective analysis of 12 neonates undergoing arterial switch surgery.
- Continuous monitoring of arterial and central venous pressures.
- Measurement of cardiac index (CI), stroke volume index (SVI), systemic vascular resistance index (SVRI), GEDI, and extravascular lung water index (ELWI) using TPTD.
Main Results:
- CI and SVI were significantly lower, while ELWI and SVRI were higher in both open and closed chest conditions compared to postextubation.
- A strong correlation was observed between changes in GEDI and CI in the open chest condition (r = 0.93; P < 0.006).
- CI correlated significantly with SVRI only in the closed chest condition (r = -0.92; P < 0.001).
Conclusions:
- TPTD is a valuable tool for assessing cardiac function in neonates post-arterial switch surgery.
- Establishing normal volumetric parameter values is crucial for effective therapeutic guidance in this patient group.
