Evaluation of gastric intramucosal pH during and after pediatric cardiac surgery

Abstract

With current equipment, tonometry cannot be recommended for the management of pediatric patients after cardiac surgery. However, as a semi-invasive method tonometry deserves further evaluation.

Monitorização hemodinâmica em cirurgia cardíaca pediátrica

“…Na população pediátrica, a determinação do pH da mucosa gástrica pela tonometria provou ser um método fidedigno na mensuraçãoção da perfusão esplâncnica 84 . Entretanto, em cirurgia cardíaca pediátrica, seu valor como preditor de morbidade e mortalidade é controverso 85,86 . Pérez e cols.…”

Performance of automated air tonometry under hypothermia

“…Following an equilibration period of 10 min, the air is automatically sampled and analysed for CO 2 by means of an infrared sensor. In order to avoid depletion of luminal CO 2 and to reduce equilibration times, the aspirated gas mixture is re-filled into the sampling balloon [5].There is an increasing interest in assessment of gastric luminal P r CO 2 during cardiac surgery with hypothermic cardio-pulmonary bypass [6][7][8]. Thus the aim of the present study was to evaluate performance of automated air tonometric assessment of P r CO 2 during normo-and hypothermia using the TONOCAP Ò in an in vitro set-up.…”

“…There is an increasing interest in assessment of gastric luminal P r co 2 during cardiac surgery with hypothermic cardio‐pulmonary bypass [6–8]. Thus the aim of the present study was to evaluate performance of automated air tonometric assessment of P r co 2 during normo‐ and hypothermia using the TONOCAP ® in an in vitro set‐up.…”

Balloon-free gastric tonometric examinations combined with the evaluation of the gastric-to-end-tidal CO2 gap in children

“…Sigmoid tonometers used to measure sigmoid mucosal pHi in adults are much smaller than adult gastric tonometers. In spite of the favourable experiences with the use of adult sigmoid tonometers in paediatric gastric tonometric investigations, it has been emphasized that a much smaller device would be needed for neonates and prematures (51,52).…”

“…, anaesthetized paediatric cases during and after surgery(52), neonates(59) and even very low birth weight infants(50) have been published. The limited data available in this field support the predictive value and clinical usefulness of gastric tonometry in a heterogeneous paediatric population.…”