BACKGROUND: A low cardiac output state can complicate the postoperative course of patients undergoing Fontan-type operations and tetralogy of Fallot repair. METHODS AND RESULTS: We investigated the effect of negative-pressure ventilation on cardiac output in 11 children in the early postoperative period after right heart surgery. All patients were initially ventilated with volume-cycled intermittent positive-pressure ventilation, and negative-pressure ventilation was delivered with the Hayek external high-frequency oscillator. Cardiac output was calculated by the direct Fick method, oxygen consumption being measured by respiratory mass spectrometry. Cardiac output was measured during intermittent positive-pressure ventilation and after 15 minutes of negative-pressure ventilation. Negative-pressure ventilation improved the cardiac output by a mean of 46% (P = .005). Heart rate did not change, and stroke volume increased by a mean of 48.5% (P = .005). Mixed venous saturation increased by 4.6% (P < .02), and consequently arteriovenous oxygen content difference fell significantly (P = .01). The systemic and pulmonary vascular resistances were reduced significantly during negative-pressure ventilation (P < .05 and P < .03, respectively). CONCLUSIONS: Negative-pressure ventilation improves cardiac output in children after total cavopulmonary connection and tetralogy of Fallot repair and may prove to be an important therapeutic option in children with the low cardiac output state.
BACKGROUND: A low cardiac output state can complicate the postoperative course of patients undergoing Fontan-type operations and tetralogy of Fallot repair. METHODS AND RESULTS: We investigated the effect of negative-pressure ventilation on cardiac output in 11 children in the early postoperative period after right heart surgery. All patients were initially ventilated with volume-cycled intermittent positive-pressure ventilation, and negative-pressure ventilation was delivered with the Hayek external high-frequency oscillator. Cardiac output was calculated by the direct Fick method, oxygen consumption being measured by respiratory mass spectrometry. Cardiac output was measured during intermittent positive-pressure ventilation and after 15 minutes of negative-pressure ventilation. Negative-pressure ventilation improved the cardiac output by a mean of 46% (P = .005). Heart rate did not change, and stroke volume increased by a mean of 48.5% (P = .005). Mixed venous saturation increased by 4.6% (P < .02), and consequently arteriovenousoxygen content difference fell significantly (P = .01). The systemic and pulmonary vascular resistances were reduced significantly during negative-pressure ventilation (P < .05 and P < .03, respectively). CONCLUSIONS: Negative-pressure ventilation improves cardiac output in children after total cavopulmonary connection and tetralogy of Fallot repair and may prove to be an important therapeutic option in children with the low cardiac output state.
Authors: Monica E Kleinman; Allan R de Caen; Leon Chameides; Dianne L Atkins; Robert A Berg; Marc D Berg; Farhan Bhanji; Dominique Biarent; Robert Bingham; Ashraf H Coovadia; Mary Fran Hazinski; Robert W Hickey; Vinay M Nadkarni; Amelia G Reis; Antonio Rodriguez-Nunez; James Tibballs; Arno L Zaritsky; David Zideman Journal: Circulation Date: 2010-10-19 Impact factor: 29.690
Authors: Monica E Kleinman; Allan R de Caen; Leon Chameides; Dianne L Atkins; Robert A Berg; Marc D Berg; Farhan Bhanji; Dominique Biarent; Robert Bingham; Ashraf H Coovadia; Mary Fran Hazinski; Robert W Hickey; Vinay M Nadkarni; Amelia G Reis; Antonio Rodriguez-Nunez; James Tibballs; Arno L Zaritsky; David Zideman Journal: Pediatrics Date: 2010-10-18 Impact factor: 7.124
Authors: Alejandro A Floh; Gustavo La Rotta; Julius Z Wermelt; Patricia Bastero-Miñón; V Ben Sivarajan; Tilman Humpl Journal: Intensive Care Med Date: 2013-02-22 Impact factor: 17.440
Authors: Long Guo; Yong Cui; Scott Pharis; Mark Walsh; Joseph Atallah; Meng-Wei Tan; Jennifer Rutledge; J Y Coe; Ian Adatia Journal: Pediatr Cardiol Date: 2013-12-19 Impact factor: 1.655