Lung mechanics in infants with left-to-right shunt congenital heart disease

Abstract

To clarify which hemodynamic measurement correlates best with lung mechanics in infants with congenital heart disease and left‐to‐right shunts, dynamic pulmonary function tests and echocardiography were performed in 26 infants with such disease (study infants) and in 37 normal, healthy infants (control infants). The tidal volume and pulmonary compliance (CL) were lower and airway resistance higher in infants with congenital heart disease than in control infants. A significant correlation was demonstrated between CL, expiratory resistance (Re), and the right pulmonary artery‐to‐aortic size ratio (RPA/DAO). CL and Re also correlated well with the corrected acceleration time √RR ratio (ACT/√RR: ACT, acceleration time and RR: length of the cardiac cycle) of pulmonary flow velocity. Stepwise multiple regression analysis revealed that RPA/DAO correlated best with both CL and Re. It is concluded that infants with congenital heart disease and left‐to‐right shunts have lower lung compliance and higher expiratory airway resistance than normal children, and that RPA/DAO is the echocardiographic parameter that correlates best with the changes in lung mechanics. Pediatr Pulmonol. 1996; 21:42–47. © 1996 Wiley‐Liss, Inc.

Preoperative lung function in newborn infants with univentricular hearts compared with healthy controls

“…Previous studies of infants with congenital heart disease have found similar changes (8)(9)(10). A study of infants with left-to-right shunt by Yau et al (11) found a reduction in compliance of the same magnitude as our study. The reduced compliance has been attributed to increased pulmonary blood flow and increased pulmonary artery pressure (8,11,12).…”

“…A study of infants with left-to-right shunt by Yau et al (11) found a reduction in compliance of the same magnitude as our study. The reduced compliance has been attributed to increased pulmonary blood flow and increased pulmonary artery pressure (8,11,12). We had no measure of pulmonary artery pressure, but we found a relationship between an estimation of pulmonary blood flow and compliance of the respiratory system and between pulmonary vasculature markings and compliance of the respiratory system.…”

High-frequency oscillatory ventilation and short-term outcome in neonates and infants undergoing cardiac surgery: a propensity score analysis

“…[23], CPB is responsible for an obstructive process in the bronchi, leading to bronchospasm and acidosis. Bronchospasm is also a frequent postoperative finding in patients with a large preoperative left to right shunt [28]. Thus, the use of HFOV to treat respiratory acidosis in an attempt to decrease PVR after CPB appears justified.…”

Abnormal ventilatory response to exercise in young adults operated for ventricular septal defect in early childhood: A long-term follow-up

“…Moreover, preoperative pulmonary hyperperfusion may have a harmful impact on the small airways causing peripheral airway obstruction and alterations of the visco-elastic properties of the lung [18][19][20][21][22]. Nevertheless, Zaqout et al [10] found significantly better pulmonary outcome after percutaneous ASD-closure than after surgery.…”