Combining low inspired oxygen and carbon dioxide during mechanical ventilation for the Norwood procedure

Keidan, Ilan; Mishaly, David; Berkenstadt, Haim; Perel, Azriel

doi:10.1046/j.1460-9592.2003.00975.x

Cited by 18 publications

(10 citation statements)

References 6 publications

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“…Due to the disturbances of blood flow balance, pulmonary blood flow and blood oxygenation increase at the cost of decreased systemic flow, including coronary blood flow, what causes heart ischemia. Some authors suggest enriching the mixture of respiratory gases with carbon dioxide, [ 13 , 14 ] which exerts a potent vasoconstrictive effect on pulmonary vessels with a minimal effect on the resistance of peripheral vessels. No carbon dioxide was employed in the mixture of respiratory gases in our patients.…”

Section: Discussionmentioning

confidence: 99%

Effect of acid–base balance on postoperative course in children with hypoplastic left heart syndrome after the modified Norwood procedure

Gładki

Składzień²,

Żurek³

et al. 2017

Medicine

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Hypoplastic left heart syndrome (HLHS) is a congenital heart defect that requires 3-stage cardiac surgical treatment and multidirectional specialist care. The condition of newborns in the first postoperative days following the modified Norwood procedure is characterized by considerable hemodynamic instability that may result in a sudden cardiac arrest. It is believed that the most important cause of hemodynamic instability is the fluctuations in redistribution between pulmonary and systemic blood flow.The paper analyzes the postoperative course in 40 neonates with HLHS following the modified Norwood procedure performed under deep hypothermic cardiopulmonary bypass hospitalized in Cardiac Surgical Intensive Care Unit (CSICU) in the years 2014–2015. For all hospitalized children, the arterial blood acid–base balance (ABB) parameters (pH, pO2, pCO2, HCO3, base excess (BE), and lactic acid) were measured 2 times a day during the first 5 postoperative days. The main goal of the studies is to analysis of ABB parameters and their influence on the clinical state of newborns with HLHS. Several descriptors were concerned to describe the neonates clinical state: the date of the surgery (the day of life when the child was operated on), the duration (number of days) of mechanical ventilation employment, the time of hospitalization in intensive care unit, and the total duration of treatment in CSICU.The statistical analysis of the particular ABB parameters revealed a significant dependence (P < .001) between the values of pH, pO2, pCO2, HCO3, BE, lactic acid, and all concerned descriptors of the newborn clinical state.The article shows that monitoring the ABB parameters, proper interpretation of the results, and appropriate modification of pharmacotherapy and respiratory treatment are crucial for therapeutic results and survival rates in neonates with HLHS after the modified Norwood procedure.

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Section: Discussionmentioning

confidence: 99%

Effect of acid–base balance on postoperative course in children with hypoplastic left heart syndrome after the modified Norwood procedure

Gładki

Składzień²,

Żurek³

et al. 2017

Medicine

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“…To achieve pulmonary vasoconstriction, inhaled carbon dioxide has been used to decrease pulmonary circulation, and thus increase systemic blood circulation, in neonatal patients with single-ventricle physiology (eg, hypoplastic left-heart syndrome) in the preoperative and postoperative periods. 84 This technique increases the pulmonary vascular resistance, thereby improving systemic blood flow (Q s ).…”

Section: Inhaled Carbon Dioxidementioning

confidence: 99%

“…Interestingly, only 3 subjects showed a positive response in the postoperative period when CO 2 was added to the hypoxic gas. 84 …”

Section: Hypoxic Gas Mixturesmentioning

confidence: 99%

Inhaled Medical Gases: More to Breathe Than Oxygen

Gentile

2011

Respir Care

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“…These approaches have been well reported in the medical literature. [41][42][43][44][45] To optimize patient safety, comprehensive monitoring systems and carefully considered policies and procedures should be in place before utilizing either of these inhaled therapies.…”

Section: Inhaled Medical Gases: More To Breathe Than Oxygenmentioning

confidence: 99%

Neonatal and Pediatric Respiratory Care: What Does the Future Hold?

DiBlasi

Cheifetz

2011

Respir Care

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Neonatal and pediatric respiratory care continues to move forward at a truly impressive pace. Recent technologic advances and an increasing number of randomized clinical trials are leading to improved outcomes for neonates, infants, children, and adolescents with respiratory illness. The goals of this 47th RESPIRATORY CARE Journal Conference were to review pertinent recent advances in neonatal and pediatric respiratory care and, more importantly, to offer thoughts and perspectives for the future of our field. It is important to note that of the prior 46 Journal Conferences, only 2 have been dedicated to neonatal and/or pediatric respiratory care topics. It is our hope that the publication of these proceedings will provide respiratory therapists, physicians, and other members of the clinical care team a foundation on which to ponder the future of neonatal and pediatric respiratory care.

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Combining low inspired oxygen and carbon dioxide during mechanical ventilation for the Norwood procedure

Abstract: Low inspired oxygen and CO2 have an additive vasoconstrictive effect on the pulmonary vessels. The use of both of these ventilatory manoeuveres is less effective postoperatively compared with the prebypass period.

Cited by 18 publications

References 6 publications

Effect of acid–base balance on postoperative course in children with hypoplastic left heart syndrome after the modified Norwood procedure

Effect of acid–base balance on postoperative course in children with hypoplastic left heart syndrome after the modified Norwood procedure

Inhaled Medical Gases: More to Breathe Than Oxygen

Neonatal and Pediatric Respiratory Care: What Does the Future Hold?

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