Document Detail


Negative Pressure Ventilation as a Therapy for Post-operative Complications in a Patient with Single Ventricle Physiology.
MedLine Citation:
PMID:  21493139     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To report the use of negative pressure ventilation as a therapeutic rescue in a patient with post-operative complications of Kawashima procedure. DESIGN: Case report. SETTING: Paediatric cardiac critical care unit in a tertiary care teaching hospital. PATIENT: Nine month-old patient with single ventricle physiology developed complications after Kawashima procedure that were worsened by use of positive pressure ventilation. INTERVENTION: Utilisation of negative pressure ventilation due to its unique cardiopulmonary interactions and haemodynamic effects. MEASUREMENTS AND MAIN RESULTS: There was gradual and persistent improvement in the passive diastolic pulmonary blood flow through the Kawashima circuit along with improvement in oxygenation and ventilation. The patient was successfully weaned off ventilator support and discharged to home. CONCLUSION: Patients with single ventricle physiology depend on passive diastolic blood flow to the lungs through surgical pathways such as Fontan or Kawashima circuits. Prolonged use of positive pressure ventilation can significantly affect this forward flow and result in haemodynamic compromise. Use of negative pressure ventilation with its unique cardiopulmonary interactions can be an effective rescue as demonstrated in our case.
Authors:
Shriprasad R Deshpande; Paul M Kirshbom; Kevin O Maher
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-13
Journal Detail:
Title:  Heart, lung & circulation     Volume:  -     ISSN:  1444-2892     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963739     Medline TA:  Heart Lung Circ     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier B.V.
Affiliation:
Pediatric Cardiology Division, Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA 30322, United States.
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