Methods: Spectrum Medical M3 monitor was used for 50 patients between December 2010 and June 2011. Capiox RX05 oxygenator was used for 30 patients (group 1; 21 boys, 9 girls; mean age 26.3±12.4 months), and Capiox FX05 oxygenator was used for 20 patients (group 2; 10 boys, 10 girls; mean age 22.4±12 months). Heparin dose was 400 units/kg. Activated clotting time was maintained at >500 seconds, hematocrit was maintained at 25-30%, and cardiopulmonary bypass flow was maintained at 125-150 mL/kg/minute. Moderate hypothermia (28- 34 degrees), alfa stat blood gas management, and antegrade isothermic blood cardioplegia were used.

Results: No mortality was observed in group 1. In group 2, one patient died due to pulmonary hypertension. Two patients needed prolonged respiratory support for pneumonia in group 1 and group 2. In group 1, the mean number of arterial gaseous emboli was 32573 (23063-60051) (25-75% percentile), and mean volume of arterial gaseous emboli was 4.2 mL (2.1-7.5 mL) (25-75% percentile). In group 2, the mean number of arterial gaseous emboli was 25053 (9096.3-37352.3) (25-75% percentile), and mean volume of arterial gaseous emboli was 1.1 mL (0.5-3.2 mL) (25-75% percentile) (p value for t he number of a rterial emboli was 0.043, and p value for arterial emboli volume was 0.001).

Conclusion: Spectrum Medical M3 monitor is a useful device for monitoring gaseous emboli in pediatric cardiac surgery. Terumo Capiox FX05 oxygenator with built in arterial filter may be more effective for the prevention of gaseous emboli than Terumo Capiox RX05 oxygenator without arterial filter.