Evaluation of methods for monitoring transpulmonary gradien after total cavopulmonary connection surgery / 中国小儿急救医学

ABSTRACT

Objective:To explore the reliability of estimated transpulmonary gradient(TPG)by comparing the measured TPG with the estimated TPG in echocardiography.Methods:The cardiothoracic surgery database of Shanghai Children′s Medical Center was reviewed.Children with hemodynamic monitoring and ultrasound findings who underwent total cavopulmonary connection between January 2015 and December 2018 were included.TPG was calculated separately according to the formula.Intraclass correlation efficient was used for consistency test.Results:Finally, 27 patients were selected, including 16 males and 11 females with age(4.0±1.6)years old, weight(15.2±3.3)kg and height(99.1±11.2)cm.There were nine cases (33.3%) of right ventricular double outlet and seven cases (25.9%) of pulmonary atresia.For hemodynamic blood monitoring, TPG was 5-16(10.1±3)mmHg, and its echocardiography parameters were estimated as 5.8-20.3(11±3.3)mmHg.The ICC value was 0.117 which was less than 0.4( P=0.277). Conclusion:TPG estimated by total cavopulmonary connection pipe window during perioperative period is inaccurate and higher than actual value, so invasive hemodynamic monitoring is still recommended during perioperative period.