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British Journal of Anaesthesia, Vol 81, Issue 5 696-701, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Non-invasive aortic blood flow measurement in infants during repair of craniosynostosis

G. A. Orliaguet, P. G. Meyer, S. Blanot, M. M. Jarreau, B. Charron, H. Cuttaree, A. C. Perie, P. A. Carli and D. Renier
Department of Paediatric Anaesthesiology, Hopital des Enfants Malades, 149 rue de Sevres, 75743 Paris Cedex 15, France; Department of Paediatric Neurosurgery, Hopital des Enfants Malades, 149 rue de Sevres, 75743 Paris Cedex 15, France

We have assessed the potential clinical benefit of a new echo-Doppler device (Dynemo 3000) which provides a continuous measure of aortic blood flow (ABF) using an aortic flowmeter and a paediatric oesophageal probe, during repair of craniosynostosis in infants under general anaesthesia. The data recorded included: ABFi (i = indexed to body surface area), stroke volume (SVi), systemic vascular resistance (TSVRi), pre-ejection period (PEP), left ventricular ejection time (LVET), mean arterial pressure (MAP), heart rate (HR) and central venous pressure (CVP). Data were collected: before (T1) and 3 min after skin incision (T2), at the time of maximal haemorrhage (T3) and at the end of the procedure (T4). Twelve infants (aged 7.0 (range 6-12) months) were included. ABFi, MAP and CVP were significantly lower at T3 compared with T1 (2.0 (0.8) vs 3.0 (0.8) litre min-1 m-2, 46.1 (5.8) vs 65.2 (8.9) mm Hg and 2.8 (1.6) vs 5.2 (2.1) mm Hg; P < 0.05). PEP/LVET ratio was significantly lower at T2 compared with T1 (0.25 (0.05) vs 0.30 (0.06)) and increased at T4 (0.36 (0.04); P < 0.05). These preliminary results suggest that this non-invasive ABF echo-Doppler device may be useful for continuous haemodynamic monitoring during a surgical procedure associated with haemorrhage in infants.
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S. Dahmani, G. A. Orliaguet, P. G. Meyer, S. Blanot, D. Renier, and P. A. Carli
Perioperative blood salvage during surgical correction of craniosynostosis in infants
Br. J. Anaesth., October 1, 2000; 85(4): 550 - 555.
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