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Hyperoxia Reduces Oxygen Consumption in Children with Pulmonary Hypertension.

Publication Type : Journal Article

Thematic Areas : Medical Sciences

Publisher : Pediatr Cardiol

Source : Pediatr Cardiol, Volume 38, Issue 5, p.959-964 (2017)

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Keywords : adolescent, blood gas analysis, Cardiac Catheterization, Cardiac Output, child, Child, Preschool, female, Humans, Hyperoxia, Hypertension, Pulmonary, infant, male, Oxygen consumption, Oxygen Inhalation Therapy, Retrospective Studies, Thermodilution

Campus : Kochi

School : School of Medicine

Department : Paediatric Cardiology

Year : 2017

Abstract : High inspired oxygen concentration (FiO  0.85) is administered to test pulmonary vascular reactivity in children with pulmonary hypertension (PH). It is difficult to measure oxygen consumption (VO) if the subject is breathing a hyperoxic gas mixture so the assumption is made that baseline VO does not change. We hypothesized that hyperoxia changes VO. We sought to compare the VO 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. VO was calculated using the equation CI = VO/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 (0.4-2.0 m). In hyperoxia compared with room air, we measured decreased VO (154 ± 38 to 136 ± 34 ml/min/m, 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, p = 0.03), pulmonary vascular resistance (9 [Formula: see text] 6 to 7 [Formula: see text] 3 WU m, 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, p=0.001). Hyperoxia decreased VO and CI and caused pulmonary vasodilation and systemic vasoconstriction in children with PH. The assumption that VO 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.

Cite this Research Publication : 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, vol. 38, no. 5, pp. 959-964, 2017.

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