Skip Navigation

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (10)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Short, J. A.
Right arrow Articles by Fletcher, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Short, J. A.
Right arrow Articles by Fletcher, R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

British Journal of Anaesthesia, 2001, Vol. 86, No. 3 349-353
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Arterial to end-tidal carbon dioxide tension difference in children with congenital heart disease{dagger}

J. A. Short1,5, S. T. Paris2, P. D. Booker3 and R. Fletcher4

1Royal Liverpool Children’s Hospital, Eaton Road, Liverpool L12 2AP, UK. 2St Luke’s University Hospital, Gwardamangia, Malta. 3University of Liverpool, Liverpool, UK. 4Manchester Royal Infirmary, Manchester, UK 5Present address: Royal Hallamshire Hospital, Sheffield, UK*Corresponding author

{dagger}Presented at the meeting of the Anaesthetic Research Society, Liverpool, March 2000.

In children with congenital cyanotic heart disease, right-to-left intracardiac shunting causes an obligatory difference between arterial and end-tidal carbon dioxide tension (PaCO2–PE'CO2) as venous blood, rich in carbon dioxide, is added to the arterial circulation. This obligatory PaCO2–PE'CO2 difference, which can be predicted from knowledge of oxygen saturation, haemoglobin concentration and PaCO2, increases as oxygen saturation decreases, most markedly when the haemoglobin concentration is high. A second possible cause of the PaCO2–PE'CO2 difference is the effect of pulmonary hypoperfusion caused by the shunt. We studied 60 children undergoing cardiac surgery and compared the predicted the PaCO2–PE'CO2 difference with measured values to investigate the extent to which additional factors influence the clinically observed PaCO2–PE'CO2. In many children, observed values were much greater than predicted, which is compatible with some degree of pulmonary hypoperfusion. However, this was not felt to represent the complete picture in all patients. Another cause of ventilation–perfusion mismatch was suspected in those children who showed a considerable improvement in oxygen saturation during ventilation with an increased FIO2. We believe that pulmonary congestion caused by large left-to-right shunts may further increase the PaCO2–PE'CO2 difference.

Br J Anaesth 2001; 86: 349–53


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 J Intensive Care MedHome page
J. Wilson, P. Russo, J. Russo, and J. D. Tobias
Noninvasive Monitoring of Carbon Dioxide in Infants and Children With Congenital Heart Disease: End-Tidal Versus Transcutaneous Techniques
J Intensive Care Med, September 1, 2005; 20(5): 291 - 295.
[Abstract] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.