Journal article
Distribution of cardiac output and oxygen delivery in an acute animal model of single-ventricle physiology
The Journal of thoracic and cardiovascular surgery, Vol.130(4), pp.1062-1070
2005
DOI: 10.1016/j.jtcvs.2005.05.033
PMID: 16214521
Abstract
Background: When single-ventricle physiology is established acutely (ie, after a Norwood procedure), the combination of limited cardiac output and hypoxemia could result in limited oxygen transport to systemic organs. This study investigates the regional distribution of cardiac output and oxygen delivery after creation of single-ventricle physiology.
Methods: Single-ventricle physiology was created in 8 piglets, and 8 other piglets served as sham control animals. Aortopulmonary shunt, echocardiography-guided atrial septostomy, tricuspid valve avulsion, and pulmonary artery occlusion allowed the left ventricle to support systemic and pulmonary circulations. Physiologic parameters and regional blood flow were determined at baseline and at 30 and 120 minutes after conversion to single-ventricle physiology. Parameters were compared by means of 1-way and 2-way analysis of variance.
Results: Single-ventricle physiology resulted in lower diastolic arterial pressure, oxygen saturation, and arterial oxygen saturation (P < .05), whereas hemoglobin was unchanged. Cerebral blood flow increased markedly in control animals (P = .04). In contrast, in single-ventricle physiology regional blood flow was unchanged in the brain, higher in the myocardium (P = .1), and mildly reduced in low-priority organs (liver, kidneys, and bowel). Cerebral oxygen delivery increased in control animals, whereas in animals with single-ventricle physiology, oxygen delivery decreased in the brain, liver, kidneys, and bowel (P < .05) and was unchanged in the myocardium. Total-body oxygen delivery decreased in animals with single-ventricle physiology (P < .001) but not in control animals. Total-body oxygen consumption was unchanged in both groups.
Conclusions: This study shows that in acute single-ventricle physiology hypoxemia and limited regional blood flow reduce oxygen transport to low-priority organs and partly to the brain. These findings might contribute to the understanding of gastrointestinal and neurologic complications in children with single-ventricle physiology.
Details
- Title: Subtitle
- Distribution of cardiac output and oxygen delivery in an acute animal model of single-ventricle physiology
- Creators
- Marco RICCI - Holtz Children's Hospital, University of Miami Miller School of Medicine, Miami, Fla, United StatesPierluca LOMBARDI - Holtz Children's Hospital, University of Miami Miller School of Medicine, Miami, Fla, United StatesAlvaro GALINDO - Holtz Children's Hospital, University of Miami Miller School of Medicine, Miami, Fla, United StatesAmelia VASQUEZ - Holtz Children's Hospital, University of Miami Miller School of Medicine, Miami, Fla, United StatesJennifer ZUCCARELLI - Holtz Children's Hospital, University of Miami Miller School of Medicine, Miami, Fla, United StatesEliot ROSENKRANZ - Holtz Children's Hospital, University of Miami Miller School of Medicine, Miami, Fla, United States
- Resource Type
- Journal article
- Publication Details
- The Journal of thoracic and cardiovascular surgery, Vol.130(4), pp.1062-1070
- Publisher
- Elsevier; Philadelphia, PA
- DOI
- 10.1016/j.jtcvs.2005.05.033
- PMID
- 16214521
- ISSN
- 0022-5223
- eISSN
- 1097-685X
- Language
- English
- Date published
- 2005
- Academic Unit
- Surgery; Cardiothoracic Surgery
- Record Identifier
- 9984051729302771
Metrics
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