Arterial blood gas analysis during bronchography in small infants

Bronchography is required in infants suffering from respiratory distress due to tracheobronchial abnormalities or pulmonary and/or cardiovascular disease. In 10 infants with ages below 1 year and 2 months bronchography was performed under halothane-oxygen anesthesia with spontaneous respiration. We measured arterial blood gases after each of the following procedures: endotracheal intubation, instillation of contrast medium, instillation of 0.5 ml/kg of saline for tracheobronchial toilet, tracheobronchial toilet and finally extubation. During the whole procedure, PaO₂ ranged from 78 to 406 mmHg. PaCO₂ 32~95 mmHg and pH 7.05~7.42. These data may be the result of increased intrapulmonary shunt due to age, general anesthesia and high oxygen concentration. Despite decreased PaO₂ or elevated PaCO₂, no obvious or severe cardiac complications were observed, and after the procedure the patients' courses were uneventful. However, we believe that bronchography should be performed with caution in infants with congestive heart failure or anemia.