| Estimation of oxygen delivery in newborns with a univentricular circulation. | |
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MedLine Citation:
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PMID: 9760295 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The management of neonates with complex congenital anomalies depends on careful interpretation of arterial blood gas values. Improved interpretation of these oxygen parameters may allow clinicians to avoid unexpected cardiovascular events. This study examined whether systemic oxygen delivery (DO2) can be maximized by the use of indices derived from oxygen saturation measurements in neonates with hypoplastic left heart syndrome. METHODS and RESULTS: For the single-ventricle heart with both circulations in parallel, we used a previously developed computer simulation to obtain DO2 as a function of systemic arterial (SaO2) and venous (SvO2) oxygen saturation, arteriovenous oxygen difference (Sa-vO2), or pulmonary-to-systemic flow ratio (Qp/Qs). We also examined the oxygen excess factor, SaO2/Sa-vO2 (Omega). We found that (1) slight increases in SaO2 may be associated with large decreases in DO2. (2) Low values for SvO2 indicate low values for DO2. (3) Curves for Sa-vO2 and Qp/Qs are redundant in the data provided. (Qp/Qs, however, provides these data in more physiologically relevant terms.) (4) High values for Qp/Qs (>4) are associated with low DO2. (5) Estimating Qp/Qs from oxygen saturation measurements may result in errors when pulmonary venous oxygen saturation is not available. (6) Maximizing DO2 is extremely difficult using SaO2, SvO2, and Qp/Qs. (7) A linear relationship exists between Omega and DO2, and this linear relationship is not altered by changes in cardiac output. CONCLUSIONS: Patients with low SvO2 values require attention. Ideally, after reducing Qp/Qs to <1.5, Omega might be a better index to guide further therapy and maximize DO2. Interventions that increased Omega would be considered beneficial, whereas interventions that decreased Omega would be considered detrimental. |
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Authors:
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O Barnea; W P Santamore; A Rossi; E Salloum; S Chien; E H Austin |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 98 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1998 Oct |
Date Detail:
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Created Date: 1998-10-28 Completed Date: 1998-10-28 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1407-13 Citation Subset: AIM; IM |
Affiliation:
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Biomedical Engineering Department, Tel Aviv University, Israel. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Output Computer Simulation* Humans Hypoplastic Left Heart Syndrome / blood, physiopathology* Infant, Newborn Models, Biological* Oxygen / blood* Pulmonary Circulation Ventricular Function, Right |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
| Comments/Corrections | |
Comment In:
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Circulation. 1999 Jul 13;100(2):213-4
[PMID:
10402534
]
Circulation. 1999 Aug 10;100(6):687-8 [PMID: 10441112 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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