Utility of pulse oximetry in the early recognition of intraoperative hypoxaemia in tetralogy of Fallot

  • Mukesh Tripathi
  • Sushil P. Ambesh
  • Soma Kaushik
Case Report


Undetected hypoxaemia in an anaesthetised patient can prove fatal. Pulse oximetry has been widely used to detect hypoxaemia and intracardiac shunts in congenital cyanotic heart diseases. In two patients with tetralogy of Fallot, intraoperative pulse oximetry was helpful in detecting hypoxaemia where the oxygen saturation fell to22 and 28 per cent with concomitant fall in PaO2. Immediate therapeutic measures were taken and patients’ oxygen saturation improved. We suggest routine use of pulse oximetry in patients undergoing corrective or palliative surgery for tetralogy of Fallot.


Pulse Oximetry Ventricular Septal Defect Ventricular Septal Defect Pulse Oximeter Congenital Cyanotic Heart Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Cote CJ, Rolf N, Liu LM, et al. A single-blind study of combined pulse oximetry and capnography in children.Anesthesiology 1991;74:980–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Meier-Stause P, Bucher HU, Hurlimann R, Konig V, Huck R. Pulse oximetry used for documenting oxygen saturation and right-to-left shunting immediately after birth.Euro Paediatr 1990;l49:851–5.CrossRefGoogle Scholar
  3. 3.
    Severinghaus JW, Naifeh KH. Accuracy of response of six pulse oximeters to profound hypoxia.Anesthesiology 1987;67:551–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Guntheroth WG, Kawabori I. Tetrad of Fallot.In Moss AJ, Adams FH, Emmanowlides GE, eds.Heart Disease in Infants, Children and Adolescents. Baltimore, Williams and Wilkins Co 1977: 276.Google Scholar
  5. 5.
    Hickey PR, Wessel DL. Anaesthesia for treatment of congenital heart disease.In Kaplan JA ed.Cardiac Anesthesia 2nd ed, Philadelphia, WB Saunders Co 1987:688.Google Scholar
  6. 6.
    McCornish PB, Thompson DEA. Respiratory disturbances in air embolism.Anaesthesia 1968;23:259–63.CrossRefGoogle Scholar
  7. 7.
    Kam CA. Infundibular spasm in Fallot’s tetralogy — An account and its management in anaesthesia.Anaesth Intensive Care 1978;6:138.PubMedGoogle Scholar
  8. 8.
    Nudel DB, Berman MA, Talner NS. Effect of acutely increasing systemic vascular resistance on oxygen tension in tetralogy of Fallot.Pediatrics 1976;58:248–51.PubMedGoogle Scholar
  9. 9.
    Severinghaus JW, Naifeh KH, Koh SO. Errors in 14 pulse oximeters during profound hypoxia.J Clinical Monitoring 1989;5:72–81.CrossRefGoogle Scholar

Copyright information

© Indian Association of Cardiovascular-Thoracic Surgeons 1994

Authors and Affiliations

  • Mukesh Tripathi
    • 1
  • Sushil P. Ambesh
    • 1
  • Soma Kaushik
    • 1
  1. 1.Department of Anaesthesiology and Critical Care MedicineSanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia

Personalised recommendations