PMID: 7523473Nov 1, 1994

Balancing the circulation: theoretic optimization of pulmonary/systemic flow ratio in hypoplastic left heart syndrome

Journal of the American College of Cardiology
O BarneaW P Santamore

Abstract

This study examined the effects of the pulmonary (QP)/systemic (QS) blood flow ratio (QP/QS) on systemic oxygen availability in neonates with hypoplastic left heart syndrome. The management of neonates with hypoplastic left heart syndrome is complex and controversial. Both before and after surgical palliation and before heart transplantation, a univentricle with parallel pulmonary and systemic circulations exists. It is generally assumed that balancing pulmonary and systemic blood flow is best to stabilize the circulation. We developed a mathematical model that was based on the simple flow of oxygen uptake in the lungs and whole-body oxygen consumption to study the effect of varying the QP/QS ratio. An equation was derived that related the key variables of cardiac output, pulmonary venous oxygen saturation and the QP/QS ratio to systemic oxygen availability. The key findings are 1) as the QP/QS ratio increases, systemic oxygen availability increases initially, reaches a maximum and then decreases; 2) for maximal systemic oxygen availability, the optimal QP/QS ratio is < or = 1; 3) the optimal QP/QS ratio decreases as cardiac output or percent pulmonary venous oxygen saturation, or both, increase; 4) the critical range of QP/QS,...Continue Reading

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Related Concepts

Dioxygen
Hypoplastic Left Heart Syndrome
Pulmonary Circulation
Cardiac Output
Anoxia
VPS52
Palliative Surgery

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