Cardiogenic oscillation in pediatric patients after cardiac surgery

Introduction

Cardiogenic oscillation is the fluctuation in flow tracing in mechanically ventilated patients. Large cardiogenic oscillation may cause autotriggering in adult patients after cardiac surgery [1] and inaccurate volume monitoring [2]. However, it is unknown how cardiogenic oscillation is problematic in pediatric patients. Therefore, we prospectively surveyed cardiogenic oscillation in pediatric patients after cardiac surgery.

Methods

We enrolled 17 pediatric patients who underwent cardiac surgery using cardiopulmonary bypass. They were mechanically ventilated with pressure-controlled ventilation. We measured the amplitude in cardiogenic oscillation and compared them between their admission to the ICU and before extubation. We performed statistical analysis with the t test and considered P < 0.05 significant.

Results

Cardiogenic oscillation was 2.1 ± 0.6 l/minute just after the surgery (Figure 1). Autotriggering occurred in seven of 17 patients when triggering sensitivity was set at 1 l/minute. Before the extubation, cardiogenic oscillation significantly decreased to 1.4 ± 0.4 l/minute when autotriggering disappeared. Intensive care including adjustment of inotropes and intravascular volume might have contributed to thedecrease in cardiogenic oscillation.

Figure 1

Cardiogenic oscillation.

Conclusion

In pediatric patients after cardiac surgery, cardiogenic oscillation was initially large but was decreasing at the extubation.