Dr. Shine Kumar K. H. currently serves as Assistant Professor at the Department of Paediatric Cardiology, School of Medicine, Kochi.

QUALIFICATION : DCH, DNB, FNB (Paediatric Cardiology)


Publication Type: Journal Article

Year of Publication Publication Type Title


Journal Article

L. Guo, Bobhate, P., Kumar, S., Vadlamudi, K., Kaddoura, T., Elgendi, M., Holinski, P., Coe, J. Y., Rutledge, J., and Adatia, I., “Hyperoxia Reduces Oxygen Consumption in Children with Pulmonary Hypertension.”, Pediatr Cardiol, 2017.[Abstract]

High inspired oxygen concentration (FiO2 > 0.85) is administered to test pulmonary vascular reactivity in children with pulmonary hypertension (PH). It is difficult to measure oxygen consumption (VO2) if the subject is breathing a hyperoxic gas mixture so the assumption is made that baseline VO2 does not change. We hypothesized that hyperoxia changes VO2. We sought to compare the VO2 measured by a thermodilution catheter in room air and hyperoxia. A retrospective review of the hemodynamic data obtained in children with PH who underwent cardiac catheterization was conducted between 2009 and 2014. Cardiac index (CI) was measured by a thermodilution catheter in room air and hyperoxia. VO2 was calculated using the equation CI = VO2/arterial-venous oxygen content difference. Data were available in 24 subjects (males = 10), with median age 8.3 years (0.8-17.6 years), weight 23.3 kg (7.5-95 kg), and body surface area 0.9 m(2) (0.4-2.0 m(2)). In hyperoxia compared with room air, we measured decreased VO2 (154 ± 38 to 136 ± 34 ml/min/m(2), p = 0.007), heart rate (91 [Formula: see text] 20 to 83 [Formula: see text] 21 beats/minute, p=0.005), mean pulmonary artery pressure (41 [Formula: see text] 16 to 35 [Formula: see text] 14 mmHg, p=0.024), CI (3.6 [Formula: see text] 0.8 to 3.3 [Formula: see text] 0.9 L/min/m(2), p = 0.03), pulmonary vascular resistance (9 [Formula: see text] 6 to 7 [Formula: see text] 3 WU m(2), p = 0.029), increased mean aortic (61 [Formula: see text] 11 to 67 [Formula: see text] 11 mmHg, p = 0.005), pulmonary artery wedge pressures (11 [Formula: see text] 8 to 13 [Formula: see text] 9 mmHg, p = 0.006), and systemic vascular resistance (12 [Formula: see text] 6 to 20 [Formula: see text] 7 WU m(2), p=0.001). Hyperoxia decreased VO2 and CI and caused pulmonary vasodilation and systemic vasoconstriction in children with PH. The assumption that VO2 remains unchanged in hyperoxia may be incorrect and, if the Fick equation is used, may lead to an overestimation of pulmonary blood flow and underestimation of PVRI.

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Journal Article

E. Francis, Kumar, S., and Kumar, R. Krishna, “Palliative stenting of patent ductus arteriosus in older children and young adults with congenital cyanotic heart disease”, Catheterization and Cardiovascular Interventions, vol. 83, pp. 1109–1115, 2014.[Abstract]

Objective To describe the indications, technique and results (early and short-term follow-up) of palliative patent ductus arteriosus (PDA) stenting in selected patients (2 years and older) with congenital cyanotic heart disease with reduced pulmonary blood flow who were not candidates for definitive surgery in the immediate future. Background Stenting of PDA as a palliation has been advocated as safe and effective procedure in neonates, but this modality is underutilized for children and adults. Methods Hospital records of patients (≥2 years) undergoing PDA stenting between January 2007 and September 2009 were reviewed. The access and approach was dictated by the anatomy of the PDA. A coronary guiding catheter or a long sheath was used to access the PDA. Coronary or peripheral stents were used for stenting. Results Fifteen patients with median age 14 years (range: 2–18 years); median weight 17.5 kg (range: 7–57 Kg) were included. Indication for intervention was hypoxia (mean saturation 69% ± 8.9%, hemoglobin 19.8 ± 2.69 g/dl), unsuitable anatomy or economic considerations. Successful stenting was accomplished in all (mean fluoroscopy time of 24.6 ± 16.7 min) with no complications and the saturations improved to mean of 88% ± 2.3 %. The most recent oxygen saturations on follow-up (median: 13 months; range: 1–21 months) were 82% ± 2.8%. One patient underwent corrective repair. Conclusion PDA stenting can provide effective palliation in selected older patients with cyanotic congenital heart disease. © 2013 Wiley Periodicals, Inc. More »»

NIRF 2017