Evaluation of a fiberoptic blood gas monitor in neonates with congenital heart disease

BACKGROUND: Blood gas analysis is extremely important in perioperative management of neonates with congenital heart disease, where ventilator manipulation of the pulmonary vascular resistance is crucial. Delays in blood gas analysis resulting from transport of samples to a central laboratory may compromise management of these patients. Furthermore, neonates with congenital heart defects may have lower arterial oxygen (P(aO2)) levels due to intracardiac right-to-left shunting. We evaluated the Sensicath System in neonatal patients following cardiac surgery by simultaneously measuring specimens on the central laboratory blood gas analyzer. METHODS: After patients returned from the operating room, the Sensicath System was connected to the arterial line. Blood was pulled across the sensor and re-infused to the patient after analysis. The accuracy and precision of the Sensicath System blood gas analysis results were assessed by comparison to simultaneous samples analyzed with a Corning 855 analyzer. The specimen-result turnaround time was recorded. 97 samples from 5 patients were compared. RESULTS: Blood gas analysis results from the Sensicath System showed acceptable accuracy and precision: partial pressure of oxygen (P(O2)), r² = 0.89, bias = -4.5 mm Hg, precision = 11.8; partial pressure of carbon dioxide (P(CO2)), r² = 0.59, bias = -0.4 mm Hg, precision 6.2; pH, r² = 0.78, bias = 0.03 mm Hg, precision 0.03. The central lab specimen-result turnaround time was 13.8 ± 7.1 minutes. The Sensicath System provided results after a 60-second analysis time with no blood loss. CONCLUSIONS: When compared to a Corning 855 blood gas analyzer, the Sensicath System was found to provide acceptable blood gas values, with no iatrogenic blood loss. This system may be especially helpful in infants with congenital heart defects, since rapid results are necessary for optimal patient care.