Negative pressure ventilation as haemodynamic rescue following surgery for congenital heart disease
Negative pressure ventilation as haemodynamic rescue following surgery for congenital heart disease
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DOI：
10.1007/s001340050018
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发表时间：
2000-01-01
影响因子：
38.9
通讯作者：
Penny, DJ
中科院分区：
文献类型：
--
作者：
Shekerdemian, LS;Schulze-Neick, I;Penny, DJ
低心输出量状态是法洛四联症（ToF）修复后发病率和死亡率的重要原因。这通常是传统措施难以解决的。这些患者的心输出量高度依赖于舒张期肺动脉血流，在自主呼吸过程中增强，但间歇性正压通气（IPPV）大大减少。我们报告了成功使用负压通气（NPV）作为血流动力学治疗的三个孩子的低输出继发于限制性右心室（RV）生理ToF修复后。NPV产生了显著的血液动力学改善，其中两名儿童的心输出量增加超过100%。通过增加肺血流量，从而增加心输出量，NPV可作为继发于舒张期RV功能障碍的低输出量患者的连续血液动力学治疗，这些患者不可能早期拔管。
A low cardiac output state is an important cause of morbidity and mortality following repair of tetralogy of Fallot (ToF). This is often refractory to conventional measures. The cardiac output of these patients is highly dependent on diastolic pulmonary arterial flow which is enhanced during spontaneous respiration, but much reduced by intermittent positive pressure ventilation (IPPV).We report the successful use of negative pressure ventilation (NPV) as haemodynamic therapy in three children with a low output secondary to restrictive right ventricular (RV) physiology following ToF repair. NPV produced a significant haemodynamic improvement, with increases in cardiac output of greater than 100 % in two of the children. By augmenting pulmonary blood flow, and hence cardiac output, NPV has a role as adjunctive haemodynamic therapy in patients with a low output secondary to diastolic RV dysfunction, in whom early extubation is not possible.