Continuous intra-arterial blood-gas monitoring in infants and children with cyanotic heart disease

Abstract

We have evaluated the accuracy and reliability of the Paratrend 7 continuous blood-gas analyser in infants and small children under conditions of severe hypoxaemia admitted to the paediatric intensive care unit in the perioperative period with cyanotic congenital heart disease. PO2, PCO2 and pH (hydrogen ion concentration) were measured continuously via a femoral arterial sensor and compared with 100 simultaneous paired arterial blood-gas measurements. Data were analysed by Bland-Altman analysis for bias and precision. Sensors were placed in 10 children of median age 5.43 (range 0.03-45) months, median weight 3.74 (2.79-15.4) kg and remained in place for up to 27 h after operation. PO2 values were 2.5-8.2 kPa (median 5.3 kPa). Co-oximeter saturation ranged from 37.1% to 90.6% (median 75.8%). Bias and precision values were 0.04/0.87 kPa for PO2, -0.44/0.74 kPa for PCO2 and -2.61/6.98 nmol litre-1 for hydrogen ion concentration (i.e. 0.02/0.06 for pH). We conclude that perioperative continuous arterial gas monitoring is clinically accurate under conditions of severe hypoxaemia in small infants and children with cyanotic congenital heart disease.