Document Detail


Effects of postural change on oxygen saturation and respiration in patients after the Fontan operation: platypnea and orthodeoxia.
MedLine Citation:
PMID:  16321694     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to assess whether platypnea and orthodeoxia occur in Fontan patients. We divided 14 Fontan patients into 2 groups: 8 patients who had pulmonary arteriovenous fistulas and/or intra-atrial shunts (group A) and 6 patients who had neither pulmonary arteriovenous fistulas nor intra-atrial shunts (group B). They were compared with 9 controls (group C). Arterial oxygen saturation, minute ventilation per body weight and ventilatory equivalent for carbon dioxide were measured in the supine and then sitting positions. In group A, 1 patient had platypnea and 3 patients had orthodeoxia (changes in the saturation from the supine position to the sitting position were -4% to -7%) accompanied with slight hyperpnea, and all 4 patients had both pulmonary arteriovenous fistulas and intra-atrial shunts. Contrary, patients in group B had neither platypnea nor orthodeoxia. The saturation was significantly lower and the minute ventilation was significantly higher in the sitting position than in the supine position in group A (p < 0.05). The other groups showed no significant difference in the saturation or the minute ventilation between the 2 positions. All groups showed the ventilatory equivalent was significantly higher in the sitting position than in the supine position (p < 0.05 to 0.01). We demonstrated platypnea and orthodeoxia in Fontan patients with pulmonary arteriovenous fistulas and intra-atrial shunts. We believe platypnea and orthodeoxia should be regard as a complication in Fontan patients with pulmonary arteriovenous fistulas and/or intra-atrial shunts.
Authors:
Hiroshi Suzuki; Hideo Ohuchi; Yoshimi Hiraumi; Kenji Yasuda; Shigeyuki Echigo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  106     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-02     Completed Date:  2006-03-16     Revised Date:  2006-07-12    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  211-7     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Suita, Osaka, Japan. hsuzukc562@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Arteriovenous Fistula / congenital,  physiopathology,  surgery*,  ultrasonography
Case-Control Studies
Child
Dyspnea / physiopathology
Echocardiography
Exercise Test
Female
Fontan Procedure*
Heart Catheterization
Heart Septal Defects, Atrial / physiopathology,  surgery*,  ultrasonography
Humans
Male
Oximetry
Oxygen / metabolism*
Posture*
Pronation
Pulmonary Artery / abnormalities
Pulmonary Gas Exchange
Pulmonary Veins / abnormalities
Respiratory Function Tests
Statistics, Nonparametric
Supination
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

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