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Titolo:
Pulmonary vascular-bronchial interactions: acute reduction in pulmonary blood flow alters lung mechanics
Autore:
Schulze-Neick, I; Penny, DJ; Derrick, GP; Dhillon, R; Rigby, ML; Kelleher, A; Bush, A; Redington, AN;
Indirizzi:
Great Ormond St Hosp Children, Cardiothorac Unit, London WC1 3JN, England Great Ormond St Hosp Children London England WC1 3JN on WC1 3JN, England Royal Brompton & Harefield NHS Trust, Dept Paediat, London SW3 6NP, England Royal Brompton & Harefield NHS Trust London England SW3 6NP 6NP, England Royal Brompton & Harefield NHS Trust, Dept Anaesthesiol, London SW3 6NP, England Royal Brompton & Harefield NHS Trust London England SW3 6NP 6NP, England
Titolo Testata:
HEART
fascicolo: 3, volume: 84, anno: 2000,
pagine: 284 - 289
SICI:
1355-6037(200009)84:3<284:PVIARI>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
RESPIRATORY SYSTEM RESISTANCE; CHILDREN; HYPERTENSION; ENGORGEMENT; VENTILATION; PRESSURE; DEFECTS; VOLUME;
Keywords:
pulmonary blood flow; lung mechanics; catheter intervention; cardiopulmonary interaction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Redington, AN Great Ormond St Hosp Children, Cardiothorac Unit, Great Ormond St, London WC1 3JN, England Great Ormond St Hosp Children Great Ormond St London England WC1 3JN
Citazione:
I. Schulze-Neick et al., "Pulmonary vascular-bronchial interactions: acute reduction in pulmonary blood flow alters lung mechanics", HEART, 84(3), 2000, pp. 284-289

Abstract

Background-Postoperative pulmonary hypertension in children after congenital heart surgery is a risk factor for death and is associated with severe acute changes in bath pulmonary vascular resistance and lung mechanics. Objective-To examine the impact of changes in pulmonary blood flow on lungmechanics in preoperative children with congenital heart disease, in orderto assess the cause-effect relation of pulmonary vascular-bronchial interactions. Design-Prospective, cross sectional study. Setting-Cardiac catheterisation laboratory, general anaesthesia with mechanical ventilation. Interventions-variation of pulmonary blood flow (QF) by either balloon occlusion of an atrial septal defect before interventional closure, or by complete occlusion of the pulmonary artery during balloon pulmonary valvuloplasty for pulmonary valve stenosis. Main outcome measures-Ventilatory tidal volume (Vt), dynamic respiratory system compliance (Cdyn), respiratory system resistance (Rrs). Results-28 occlusions were examined in nine patients with atrial septal defect (median age 9.5 years) and 22 in eight patients with pulmonary stenosis (median age 1.2 Sears). Normalisation of Qp during balloon occlusion of atrial septal defect caused no significant change in airway pressures and Rrs, but there was a small decrease in Vt (mean (SD): 9.61 (0.85) to 9.52 (0.97) ml/kg; p < 0.05) and Cdyn (0.64 (0.11) to 0.59 (0.10) ml/cm H2O*kg; p <0.01). These changes were more pronounced when there was complete cessation of Qp during balloon valvuloplasty in pulmonary stenosis, with a fall in Vt (9.71 (2.95) to 9.32 (2.84) ml/kg; p < 0.05) and Cdyn (0.72 (0.29) to 0.64 (0.26) ml/cm H2O*kg; p < 0.001), and there was also an increase in Rrs (25.1 (1.7) to 28.8 (1.6) cm H2O/litre*s; p < 0.01). All these changes exceeded the variability of the baseline measurements more than threefold. Conclusions-Acute changes in pulmonary blood flow are associated with simultaneous changes in lung mechanics. While these changes are small they may represent a valid model to explain the pathophysiological impact of spontaneous changes in pulmonary blood flow in clinically more critical situationsin children with congenital heart disease.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 10:22:28