Document Detail

Manipulating parallel circuits: the perioperative management of patients with complex congenital cardiac disease.
MedLine Citation:
PMID:  14694949     Owner:  NLM     Status:  MEDLINE    
In all patients undergoing cardiac surgery, the effective delivery of oxygen to the tissues is of paramount importance. In the patient with relatively normal cardiac structures, the pulmonary and systemic circulations are relatively independent of each other. In the patient with a functional single ventricle, the pulmonary and systemic circulations are dependent on the same pump. As a consequence of this interdependency, the haemodynamic changes following complex palliative procedures, such as the Norwood operation, can be difficult to understand. Comparison of the newly created surgical connections to a simple set of direct current electrical circuits may help the practitioner to successfully care for the patient. In patients undergoing complex palliations, the pulmonary and systemic circulations can be compared to two circuits in parallel. Manipulations of variables, such as resistance or flow, in one circuit, can profoundly affect the performance of the other circuit. A large pulmonary flow might result in a large increase in the saturation of haemoglobin with oxygen returning to the heart via the pulmonary veins at the expense of a decreased systemic flow. Accurate balancing of these parallel circulations requires an appreciation of all interventions that can affect individual components of both circulations.
John Lawrenson; Benedicte Eyskens; Dirk Vlasselaers; Marc Gewillig
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology in the young     Volume:  13     ISSN:  1047-9511     ISO Abbreviation:  Cardiol Young     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-12-25     Completed Date:  2004-04-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  England    
Other Details:
Languages:  eng     Pagination:  316-22     Citation Subset:  IM    
Department of Paediatric Cardiology, Gasthuisberg University Hospital, Catholic University of Leuven, Belgium.
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MeSH Terms
Cardiac Surgical Procedures*
Heart Defects, Congenital / physiopathology*,  surgery
Hemodynamics / physiology
Hypoplastic Left Heart Syndrome / physiopathology,  surgery
Infant, Newborn
Oxygen / blood
Palliative Care*
Perioperative Care
Pulmonary Circulation
Vascular Resistance
Reg. No./Substance:

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