Increased systemic cardiac output improves arterial oxygen saturation in bidirectional cavopulmonary shunt.
Increased systemic cardiac output improves arterial oxygen saturation in bidirectional cavopulmonary shunt.
复制标题
增加的全身心输出量可改善双向腔肺分流中的动脉氧饱和度。
DOI：
10.1007/s00380-013-0438-7
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Torii S
中科院分区：
文献类型：
--
作者：
Oka N;Miyaji K;Kitamura T;Itatani K;Yoshii T;Inoue N;Fukunishi T;Shibata K;Torii S
双向腔静脉分流术（BCPS）后动脉血氧饱和度（SaO 2）较低，预后不良。下腔静脉血氧饱和度（SivcO 2）以及肺血流量/体循环血流量比（Qp/Qs）影响SaO 2。本研究的目的是确定是否应该增加SivcO 2或Qp/Qs，以获得更好的结果后BCPS。纳入了48例接受BCPS的患者。收集患者年龄、体重、SivcO 2、Qp/Qs、肺动脉压力和阻力、肺动脉面积指数、心室形态、房室瓣返流、肺动脉成形术史等资料。采用逐步多元Logistic回归分析，探讨影响BCPS术后SaO 2的主要因素。SivcO 2与SaO 2呈显著相关（r= 0.771，P < 0.00001）。Qp/Qs与SaO 2无明显相关性（r= 0.358，P < 0.05）。逐步Logistic回归分析显示，SivcO 2（r= 0.49，95%CI 0.37- 0.62，P < 0.0001）和Qp/Qs（r= 11.1，95%CI 3.3- 18.9，P = 0.007）对BCPS后SaO 2影响最大。由于SivcO 2与SaO 2的相关性强于Qp/Qs，因此，尽管提高Qp/Qs和提高心输出量均可提高SaO 2，但提高心输出量应先于Qp/Qs，以提高BCPS后的SaO 2。
The low arterial oxygen saturation (SaO2) after bidirectional cavopulmonary shunt (BCPS) predicts poor prognosis. The venous oxygen saturation of inferior vena cava (SivcO2), as well as the pulmonary blood flow/systemic blood flow ratio (Qp/Qs) affects the SaO2. The purpose of this study is to determine whether SivcO2orQp/Qsshould be increased to achieve better outcomes after BCPS. Forty-eight patients undergoing BCPS were included. Data of patients’ age and body weight, SivcO2,Qp/Qs, pulmonary artery (PA) pressure and resistance, PA area index, morphology of ventricle, atrioventricular valve regurgitation, and history of PA plasty were collected. Stepwise multiple logistic regression analyses were used to investigate which of the factors most affected the SaO2after BCPS. There was a significant correlation between SivcO2and SaO2(r= 0.771,P< 0.00001). There was no strong correlation betweenQp/Qsand SaO2(r= 0.358,P< 0.05). Stepwise multiple logistic regression analyses revealed that both SivcO2(r= 0.49, 95 % confidence interval (CI) 0.37–0.62,P< 0.0001) andQp/Qs(r= 11.1, 95 % CI 3.3–18.9,P= 0.007) most affected SaO2after BCPS. Since the SivcO2has a stronger correlation thanQp/Qswith SaO2, despite the fact that both raisingQp/Qsand raising cardiac output can increase SaO2, raising cardiac output should be considered prior toQp/Qsto raise the SaO2after BCPS.