CONTRIBUTION OF SUPERIOR VENA-CAVAL FLOW TO TOTAL CARDIAC-OUTPUT IN CHILDREN - A DOPPLER-ECHOCARDIOGRAPHIC STUDY
CONTRIBUTION OF SUPERIOR VENA-CAVAL FLOW TO TOTAL CARDIAC-OUTPUT IN CHILDREN - A DOPPLER-ECHOCARDIOGRAPHIC STUDY
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DOI：
10.1161/01.cir.92.7.1860
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发表时间：
1995-10-01
期刊：
影响因子：
37.8
通讯作者：
ALPERT, BS
中科院分区：
文献类型：
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作者：
SALIM, MA;DISESSA, TG;ALPERT, BS
研究背景：下腔静脉吻合术后，上级腔静脉血流作为有效的肺血流，是影响体循环动脉饱和度的最重要因素。确定该血流的量将允许更好地理解该吻合术后的循环生理。本研究的目的是确定在上级腔静脉的体积流量，并评估其贡献的心输出量作为children growth.Methods和结果使用二维和多普勒超声心动图，我们测量了直径和平均流速在上级腔静脉和肺动脉的145名健康儿童。我们计算了每支血管的容积流量，并确定了上级腔静脉流量与总心输出量的比值。心输出量和上级腔静脉血流量随年龄和体表面积的增加而增加。新生儿上级腔静脉血流量占心输出量的49%。在2.5岁时，这一缴款增加到最高55%。之后，有一个缓慢下降的比率，上级腔静脉肺动脉流量，它达到了成人值的35%，6.6岁。结论有一个成熟的变化，在上级腔静脉的贡献，总心输出量的儿童。这很可能与躯体生长和身体部分比例的变化有关。这种血流成熟可以解释腔静脉吻合术后婴儿的全身饱和度高于年龄较大的儿童。
Background After a cavopulmonary anastomosis, the superior vena caval flow, by virtue of being the effective pulmonary blood flow, is the most important factor influencing the systemic arterial saturation. Determination of the amount of this blood flow will allow a better understanding of the physiology of the circulation after this anastomosis. The purposes of this study were to determine the volumetric flow in the superior vena cava and to evaluate its contribution to the cardiac output as children grow.Methods and Results Using two-dimensional and Doppler echocardiography, we measured the diameter of and mean flow velocities in the superior venae cavae and the pulmonary arteries of 145 healthy children. We calculated the volumetric flow in each vessel and determined the ratio of superior vena caval flow to total cardiac output. Cardiac output and superior vena caval flow increased with increasing age and body surface area. The superior vena caval flow accounted for 49% of cardiac output in newborn infants. This contribution increased to a maximum of 55% at the age of 2.5 years. Afterward, there was a slow decline in the ratio of superior vena caval-pulmonary arterial flow; it reached the adult value of 35% by 6.6 years of age.Conclusions There is a maturational change in the superior vena caval contribution to total cardiac output in children. This is most likely related to somatic growth and changes in body segment proportions. This flow maturation may explain the higher systemic saturation in infants compared with older children after cavopulmonary anastomosis.