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

Br J Anaesth. 1998 Nov;81(5):696-701. doi: 10.1093/bja/81.5.696.

Abstract

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.

Publication types

  • Clinical Trial

MeSH terms

  • Anesthesia, General
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / physiopathology*
  • Blood Loss, Surgical*
  • Craniosynostoses / surgery*
  • Echocardiography, Doppler
  • Echocardiography, Transesophageal
  • Feasibility Studies
  • Hemodynamics
  • Humans
  • Infant
  • Monitoring, Intraoperative / methods*
  • Prospective Studies