Paediatric anaesthesia & critical care
Association of Intraoperative PaCO2-EtCO2 Gradient With Need for Pulmonary Blood Flow Reconditioning After Bilateral Pulmonary Artery Banding in Hypoplastic Left Heart Syndrome
Authors' conclusion
The intraoperative PaCO2-EtCO2 gradient was associated with the subsequent need for urgent pulmonary blood flow reconditioning after bPAB in neonates with HLHS.
Study context
- Population
- Neonates with hypoplastic left heart syndrome (HLHS) undergoing bilateral pulmonary artery banding (bPAB), 2018–2023
- Participants
- 39 neonates
- Exposure
- Intraoperative PaCO2-EtCO2 gradient in neonates requiring band loosening or tightening vs no reconditioning after bPAB
- Controln = 30reference
- Excessive bandingn = 5
- Loose bandingn = 4
- Outcome
- Intraoperative PaCO2-EtCO2 gradient and EtCO2/PaCO2 ratio, compared among groups
- Follow-up
- Intraoperatively
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
PaCO2-EtCO2 gradient, change after bPAB
| Group | Value | Before bPAB |
|---|---|---|
| Excessive banding | 13.9 (SD 3.3) mmHg | 6.6 ± 2.5 |
Excessive banding
Value13.9 (SD 3.3) mmHg
Before bPAB6.6 ± 2.5
- Gradient increased significantly after bPAB in Excessive banding
- P < 0.05
Observational data: associations, not effects.
Further findings
ROC analysis for subsequent urgent pulmonary blood flow reconditioning (exploratory)
- AUC, PaCO2-EtCO2 gradient (cutoff 8.8 mmHg)
- 0.906
- AUC, EtCO2/PaCO2 ratio (cutoff 0.792)
- 0.915
- Exploratory
Original publication
Association of Intraoperative PaCO2-EtCO2 Gradient With Need for Pulmonary Blood Flow Reconditioning After Bilateral Pulmonary Artery Banding in Hypoplastic Left Heart Syndrome. J Cardiothorac Vasc Anesth. Published 16 August 2026. doi:10.
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