NDLI: Changes in Pulmonary Vascular Resistance in Infants and Children with Left-to-Right

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Changes in Pulmonary Vascular Resistance in Infants and Children with Left-to-Right

Content Provider	CiteSeerX
Author	Auld, P. A. M. Johnson, A. L. Gibbons, J. E. Mcgregor, M.
Abstract	OF THE several factors that must be assessed in selecting the optimum time for surgery in infants and children with left-to-right intracardiac shunts, the extent of elevation of pulmonary vascular resistance is one of the more important. Opinion is di-vided as to whether pulmonary vascular re-sistance in these cases can progressively rise and if so with sufficient frequency to influ-ence the optimum age for surgery. To obtain further information on this problem the rec-ords of all such patients who had had two or more successful catheterization studies in our laboratory were reviewed. Material and Method The data in this report are based on cathe-terization studies performed on 17 patients with intracardiac left-to-right shunts and sig-nificant pulmonary hypertension. The sub-jects were not randomly selected. Among other reasons, repeat catheterization studies were performed to re-evaluate cases with known elevation of pulmonary vascular re-sistance or because of clinical x-ray and elec-trocardiographic evidence suggesting a change in pulmonary vascular resistance. Catheteri-zation studies were performed in the conven-tional manner. Blood samples were analyzed for oxygen by the manometric technic of Van Slyke and Neill or by a whole blood oximeter technic. ' In certain cases systemic arterial saturation was measured by an ear oximeter.2 For the purpose of calculation of pulmo-nary (Qp) and systemic (Qs) flows, oxygen consumption was assumed from the values of Rudolph and Cayler.3 Pulmonary vascular resistance was computed by the formula
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