Effects of pentoxifylline (trental) on blood flow, viscosity, and oxygen transport in young adults with inoperable cyanotic congenital heart disease

1994 ◽  
Vol 15 (2) ◽  
pp. 66-70 ◽  
Author(s):  
W. Berman ◽  
N. Berman ◽  
D. Pathak ◽  
S. C. Wood
Keyword(s):  
Congenital Heart Disease ◽  
Blood Flow ◽  
Young Adults ◽  
Heart Disease ◽  
Oxygen Transport ◽  
Congenital Heart ◽  
Cyanotic Congenital Heart Disease

Effect of Variation in Arterial Carbon Dioxide Levels on Cerebral-Somatic Oxygenation in Children with Cyanotic Congenital Heart Disease

2018 ◽  
pp. 1-6
Keyword(s):  
Carbon Dioxide ◽  
Congenital Heart Disease ◽  
Blood Flow ◽  
Heart Disease ◽  
Infrared Spectroscopy ◽  
Congenital Heart ◽  
Near Infrared ◽  
Cyanotic Congenital Heart Disease ◽  
Anesthesia Induction ◽  
Arterial Blood

Background: Hypocapnia is suggested in decreasing pulmonary vascular resistance in cyanotic congenital heart disease patients undergoing definitive repair. But its effects on cerebral and renal circulation are unclear. Hence the effect of changes in arterial blood carbon dioxide tensions (PaCo2 ) on cerebral (ScO2 %) and renal (SsO2 %) oxygenation indices using Near Infrared spectroscopy (NIRS) is examined. Methods: We did a prospective observational study in sixty-eight children who underwent elective cardiac surgery for various cyanotic congenital heart diseases. PaCo2 , ScO2 % and SsO2 % were obtained before induction of anesthesia, after anesthesia induction at normocapnic or mild hypercapnic ventilation (EtCo2 =40 mmHg) and again at hypocapnic ventilation (EtCo2 =30 mmHg). Regression analysis was done between PaCo2 and NIRS-C/ScO2 % and PaCo2 and NIRS-R/SsO2 % at both EtCo2 40 and 30 mmHg. Repeated measure analysis performed to evaluate the significance of change in NIRS-C and NIRS-R from pre-anesthesia induction to when EtCo2 was 40 and then 30 mmHg post anesthesia induction. Results: With decrease in EtCo2 , PaCo2 (p=0.0001), NIRS-C (p=0.0001) and NIRS-R (p=0.0001) decreased significantly. At EtCo2 of 40 and 30 mmHg, PaCo2 had significant positive correlation with NIRS-C (R2 =0.77, p=0.0001 and R2 =0.92, p=0.0001 respectively) and had insignificant correlation with NIRS-R (R2 =0.03, p=0.12 and R2 =0.008, p=0.46 respectively). Significant changes in NIRS-C {p=0.0001} and NIRS-R {p=0.0001} occurred from pre-induction to when EtCo2 was 40 and then to 30 mmHg. Conclusion: A decrease in NIRS-C and NIRS-R is probably from decreased cerebral and splanchnic blood flow during hypocapnic ventilation, leading to demand supply mismatch. Hypocapnic ventilation in cyanotic children has potential to cause cerebral hypoxia. Abbreviations: CCHD: Cyanotic Congenital Heart Disease; QP: Pulmonary blood flow; Do2 : Oxygen delivery; SpO2 : peripheral pulse oximetry; NIRS: Near Infrared Spectroscopy; NIRS-C/ScO2 %: Regional Cerebral Oxygen saturation; NIRS-R/SsO2 %: Regional Somatic/renal Oxygen saturation; HCT: Hematocrit; ECG: Electrocardiography; CPB: cardiopulmonary bypass; TOF: Tetralogy of fallot; BDG: Bidirectional Glenn Shunt; BT shunt: Blalock Taussig shunt; DORV: Double outlet right ventricle; FiO2 : Inspired oxygen concentration; ABG: Arterial blood gas; PaO2 : Arterial oxygen partial pressure; PaCo2 : Arterial carbon dioxide partial pressure; HR: Heart rate; MAP: Mean Arterial Pressure; CVP: Central Venous Pressure

Prolonged Prostaglandin E1 Infusion in an Infant With Cyanotic Congenital Heart Disease

PEDIATRICS ◽  
1978 ◽  
Vol 61 (4) ◽  
pp. 534-536
Author(s):  
Alan B. Lewis ◽  
Paul R. Lurie
Keyword(s):  
Congenital Heart Disease ◽  
Blood Flow ◽  
Heart Disease ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Pulmonary Blood Flow ◽  
Congenital Heart ◽  
Prostaglandin E1 ◽  
Ductus Arteriosus ◽  
Cyanotic Congenital Heart Disease

A small-for-gestational-age premature infant with severe tetralogy of Fallot was treated with prostaglandin E1 to dialate the ductus arteriosus and increase pulmonary blood flow. The infusion was continued for 29 days without complication at which time surgery was performed.

scholarly journals Pulmonary Embolism in a Critically Ill Infant with Univentricular Parallel Circulation

2021 ◽  
Vol 11 (01) ◽  
pp. e212-e215
Author(s):  
Kazuhiro Shoya ◽  
Jun Maeda ◽  
Hiroki Nagamine ◽  
Akihiro Shimotakahara ◽  
Yukihiro Yoshimura ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Congenital Heart Disease ◽  
Blood Flow ◽  
Heart Disease ◽  
Pulmonary Blood Flow ◽  
Congenital Heart ◽  
Venous Catheter ◽  
Cyanotic Congenital Heart Disease ◽  
Central Venous ◽  
Sudden Decrease

AbstractA 3-month-old infant patient with hypoplastic left heart syndrome diagnosed in the prenatal period required long-term intensive care for refractory chylothorax and chylous ascites after undergoing bilateral pulmonary artery banding at age 6 days. Weaning from mechanical ventilation was difficult due to massive edema, and a central venous catheter was required because enteral feeding was hampered by the refractory chyle leakage, for which surgery was ineffective. On the evening after central venous catheter replacement was performed, his respiratory condition suddenly deteriorated; cardiac ultrasound revealed that the left pulmonary arterial blood flow had decreased, and enhanced computed tomography demonstrated a left pulmonary embolism (PE), which was identified as the cause of a sudden decrease in the pulmonary blood flow. The patient died due to refractory septic shock at age 5 months. PEs in children, especially patients with cyanotic congenital heart disease, are difficult to diagnose because of their atypical presentation. Current diagnostic criteria are based on adult guidelines, and a few factors in the criteria, such as tachycardia and hypoxia, are difficult to apply for pediatric cyanotic patients with intracardiac or extracardiac right-to-left shunt. In fact, those criteria have lower specificities in children. In conclusion, the present case suggested that a sudden decrease in the pulmonary blood flow can aid the physicians in diagnosing PE in patients with cyanotic congenital heart disease. We need more pediatric cases and evidence of PE in children to make a PE guideline, which is specific to pediatric patients including cyanotic congenital heart disease.

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