Case Report

Case Reports: Use of Intraoperative Dye Dilution Cardiac Output in the Diagnosis of Hypoxia Due to Persistent Shunting After Intracardiac Repair with Cardiopulmonary Bypass

Department of Anesthesia and Division of Cardiothoracic Surgery, The Children’s Hospital of Philadelphia, and University of Pennsylvania School of Medicine

^* Mailing Address–Proofs & Reprint Requests: Gerald S. Lefever, M.D., Ph.D. Assistant Professor of Anesthesia & Pharmacology, Children’s Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, Pennsylvania 19104

Abstract

The rapid diagnosis of hypoxemia following repair of intracardiac defects is crucial. Although the technique of thermodilution cardiac output is popular in operating rooms and in intensive care units, it yields little information regarding intracardiac shunting. In this report of two pediatric cases, the examination of dye dilution cardiac output curves obtained intraoperatively post intracardiac repair and cardiopulmonary bypass allowed the prompt diagnosis of persistent right-to-left shunting through unrecognized cardiac defects. The dye dilution technique should be considered intraoperatively after cardiopulmonary bypass when hypoxemia may be due to residual intracardiac shunting.