Unrecognized Pulmonary Venous Desaturation Early After Norwood Palliation Confounds Q̇p:Q̇s Assessment and Compromises Oxygen Delivery

Background —Hemodynamic stability after Norwood palliation often requires manipulation of pulmonary vascular resistance to alter the pulmonary-to-systemic blood flow ratio (Q̇p:Q̇s). Q̇p:Q̇s is often estimated from arterial saturation (Sa o 2 ), a practice based on 2 untested assumptions: constant s...

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Published in:Circulation (New York, N.Y.) N.Y.), 2001-06, Vol.103 (22), p.2699-2704
Main Authors: Taeed, Roozbeh, Schwartz, Steven M., Pearl, Jeffrey M., Raake, Jenni L., Beekman, Robert H., Manning, Peter B., Nelson, David P.
Format: Article
Language:English
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Summary:Background —Hemodynamic stability after Norwood palliation often requires manipulation of pulmonary vascular resistance to alter the pulmonary-to-systemic blood flow ratio (Q̇p:Q̇s). Q̇p:Q̇s is often estimated from arterial saturation (Sa o 2 ), a practice based on 2 untested assumptions: constant systemic arteriovenous O 2 difference and normal pulmonary venous saturation. Methods and Results —In 12 patients early (≤3 days) after Norwood palliation, simultaneous arterial, superior vena caval (Ssvc o 2 ), and pulmonary venous (Spv o 2 ) oximetry was used to test whether Sa o 2 accurately predicts Q̇p:Q̇s. Stepwise multiple regression assessed the contributions of Sa o 2 , Ssvc o 2 , and Spv o 2 to Q̇p:Q̇s determination. Sa o 2 correlated weakly with Q̇p:Q̇s ( R 2 =0.08, P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.103.22.2699