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Transpulmonary thermodilution in a pediatric patient with an intracardiac left-to-right shunt

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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.

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Authors and Affiliations

  1. Hospices Civils de Lyon, Groupement Hospitalier Est, Department of Anesthesiology and Intensive Care, Louis Pradel Hospital and Claude Bernard Lyon 1 University, INSERM ERI 22, Lyon, France

    Geoffray Keller MD, Olivier Desebbe MD & Jean-Jacques Lehot MD, PhD

  2. Hospices Civils de Lyon, Groupement Hospitalier Est, Department of cardiac surgery, Louis Pradel Hospital, Lyon, France

    Roland Henaine MD

Authors
  1. Geoffray Keller MD
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  2. Olivier Desebbe MD
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  3. Roland Henaine MD
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  4. Jean-Jacques Lehot MD, PhD
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Corresponding author

Correspondence to Geoffray Keller MD.

Additional information

Keller G, Desebbe O, Henaine R, Lehot J-J. Transpulmonary thermodilution in a pediatric patient with an intracardiac left-to-right shunt.

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Keller, G., Desebbe, O., Henaine, R. et al. Transpulmonary thermodilution in a pediatric patient with an intracardiac left-to-right shunt. J Clin Monit Comput 25, 105–108 (2011). https://doi.org/10.1007/s10877-011-9281-5

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  • DOI: https://doi.org/10.1007/s10877-011-9281-5

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