CONTINUOUS INTRAARTERIAL BLOOD-GAS MONITORING IN INFANTS AND CHILDRENWITH CYANOTIC HEART-DISEASE

We have evaluated the accuracy and reliability of the Paratrend 7 cont inuous blood-gas analyser in infants and small children under conditio ns of severe hypoxaemia admitted to the paediatric intensive care unit in the perioperative period with cyanotic congenital heart disease. P O2, PCO2 and pH (hydrogen ion concentration) were measured continuousl y via a femoral arterial sensor and compared with 100 simultaneous pai red arterial blood-gas measurements. Data were analysed by Bland-Altma n 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 value s were 2.5-8.2 kPa (median 5.3 kPa). Co-oximeter saturation ranged fro m 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 t hat perioperative continuous arterial gas monitoring is clinically acc urate under conditions of severe hypoxaemia in small infants and child ren with cyanotic congenital heart disease.