PMID: 11093480Nov 28, 2000Paper

Venous saturation and the anaerobic threshold in neonates after the Norwood procedure for hypoplastic left heart syndrome

The Annals of Thoracic Surgery
George M HoffmanJames S Tweddell

Abstract

Reduction in oxygen delivery can lead to organ dysfunction and death by cellular hypoxia, detectable by progressive (mixed) venous oxyhemoglobin desaturation until extraction is limited at the anaerobic threshold. We sought to determine the critical level of venous oxygen saturation to maintain aerobic metabolism in neonates after the Norwood procedure (NP) for the hypoplastic left heart syndrome (HLHS). A prospective perioperative database was maintained for demographic, hemodynamic, and laboratory data. Invasive arterial and atrial pressures, arterial saturation, oximetric superior vena cava (SVC) saturation, and end-tidal CO2 were continuously recorded and logged hourly for the first 48 postoperative hours. Arterial and venous blood gases and cooximetry were obtained at clinically appropriate intervals. SVC saturation was used as an approximation of mixed venous saturation (SvO2). A standard base excess (BE) less than -4 mEq/L (BElo), or a change exceeding -2 mEq/L/h (deltaBElo), were used as indicators of anaerobic metabolism. The relationship between SvO2 and BE was tested by analysis of variance and covariance for repeated measures; the binomial risk of BElo or deltaBElo at SvO2 strata was tested by the likelihood ratio t...Continue Reading

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Citations

Jan 24, 2009·The Annals of Thoracic Surgery·Beth Ann JohnsonNancy S Ghanayem
Feb 6, 2004·The Journal of Thoracic and Cardiovascular Surgery·Scott M BradleyJanet M Simsic
Jan 16, 2002·The Annals of Thoracic Surgery·S M BradleyA M Atz
Jan 16, 2002·The Annals of Thoracic Surgery·D C DrinkwaterP A Chang
Feb 5, 2004·The Annals of Thoracic Surgery·Paul A ChecchiaLeonard L Bailey
Aug 21, 2003·The Journal of Thoracic and Cardiovascular Surgery·Shunji SanoShin-ichi Ohtsuki
Mar 6, 2004·The Journal of Thoracic and Cardiovascular Surgery·George M HoffmanStuart Berger
Jul 10, 2003·Critical Care Clinics·Steven M SchwartzDavid P Nelson
Jul 13, 2004·Cardiology in the Young·David P NelsonAnthony C Chang
Jan 22, 2009·Cardiology in the Young·Jeff Martin, Lara S Shekerdemian
Dec 15, 2005·Heart, Lung & Circulation·S P SettyA R Kerr
Apr 24, 2001·Current Opinion in Pediatrics·D B McElhinney, G Wernovsky
Jun 5, 2001·Current Opinion in Pediatrics·P C Laussen
Sep 26, 2003·Current Opinion in Pediatrics·Chitra RavishankarGil Wernovsky
May 15, 2008·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Jon KaufmanRobert H Friesen
Jan 11, 2008·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Beth A Johnson, Anthony C Chang
Sep 3, 2013·Current Opinion in Pediatrics·Andrew H Smith, Peter C Laussen
Feb 23, 2005·Archives of Disease in Childhood. Fetal and Neonatal Edition·U Theilen, L Shekerdemian
Sep 28, 2006·Archives of Disease in Childhood. Fetal and Neonatal Edition·Linda EdwardsWilliam Brawn
Jan 1, 2009·Medical Devices : Evidence and Research·Ad J J C BogersJan Klein
Nov 23, 2006·Intensive Care Medicine·Sylvie Di FilippoRicardo Muñoz
Mar 24, 2010·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·James S TweddellGeorge M Hoffman
Jan 28, 2010·The Annals of Thoracic Surgery·Yuji NaitoTadashi Fujiwara
Nov 7, 2007·Seminars in Thoracic and Cardiovascular Surgery·Troy E DominguezJ William Gaynor
Sep 25, 2007·The Annals of Thoracic Surgery·James S TweddellGeorge M Hoffman
Apr 9, 2005·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Scott M Bradley, Andrew M Atz
Jul 31, 2004·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Shunji SanoOsami Honjo
Apr 9, 2005·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·George M HoffmanJames S Tweddell
Jan 30, 2007·The Journal of Thoracic and Cardiovascular Surgery·Jia LiGlen S Van Arsdell
Apr 10, 2004·Journal of Cardiothoracic and Vascular Anesthesia·Nobuaki Shime
Oct 26, 2006·The Annals of Thoracic Surgery·Nancy S GhanayemJames S Tweddell
Oct 11, 2005·The Journal of Thoracic and Cardiovascular Surgery·Marco RicciEliot Rosenkranz

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