Document Detail

Hypoxic gas therapy using nitrogen in the preoperative management of neonates with hypoplastic left heart syndrome.
MedLine Citation:
PMID:  12813284     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To evaluate the efficacy of hypoxic gas therapy using nitrogen, where the fraction of inspired oxygen (Fio2) was reduced to <0.21 in patients with univentricular parallel circulation. DESIGN: Case report. SETTING: A pediatric intensive care unit at a university hospital. PATIENTS: Two neonatal patients with hypoplastic left heart syndrome admitted to the pediatric intensive care unit preoperatively. INTERVENTIONS: Nitrogen insufflation by using continuous-flow respiratory support. MEASUREMENTS AND MAIN RESULTS: We reduced the Fio2 in these patients by giving additional nitrogen to relieve pulmonary overcirculation and systemic hypoperfusion suspected by transcutaneous arterial oxygen saturation >90%, systemic arterial hypotension, and low urine output in the preoperative course. The improvement of systemic hemodynamics concomitant with decreases in transcutaneous arterial oxygen saturation <85% was accomplished by controlling Fio2 between 0.14 and 0.18. These infants were able to undergo Norwood's surgery after several days without complications relating to Fio2 reduction. CONCLUSION: Hypoxic gas therapy with nitrogen was effective clinically in preventing pulmonary overcirculation in neonatal patients with univentricular and parallel circulation.
N Shime; S Hashimoto; N Hiramatsu; T Oka; K Kageyama; Y Tanaka
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  1     ISSN:  -     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2003-06-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  38-41     Citation Subset:  -    
Departments of Anesthesiology and Intensive Care (Drs. Shime, Hashimoto, Hiramatsu, Kageyama, and Tanaka), and Pediatric Cardiology (Dr. Oka), Kyoto Prefectural University of Medicine, Kyoto, Japan.
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