[Simultaneous assessment of intra-pulmonary right-to-left shunting and of aADCO2 in 5 neonates with refractory hypoxemia (author's transl)].
Five neonates with refractory hypoxemia (aortic PO2 less than or equal to 6.7 KPa despite FiO2 = 1 and efficient artificial ventilation) were investigated in order to determine the principal mechanism of hypoxemia. PO2 values were measured (under FiO2 = 1) in a pulmonary vein, the left auricle and the aorta. They were used to distinguish intra-pulmonary shunts from extra-pulmonary shunts (though foramen ovale and/or ductus arteriosus). Simultaneous measurements of PACO2 and PaCO2 were used to assess the percentage of the ventilation output reaching hypoperfused areas. In cases with extra-pulmonary shunt, when this percentage is over 30%, pulmonary hypertension is likely. The use of both methods is useful for selecting those patients who might benefit from tolazoline.
D001784:Blood Gas Analysis; D002404:Catheterization; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000188:drug therapy / Q000503:physiopathology*; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000503:physiopathology*; D008297:Male; D010313:Partial Pressure; D011652:Pulmonary Circulation; D014043:Tolazoline / Q000627:therapeutic use
D014043:Tolazoline
L'exploration des hypoxémies réfractaires chez le nouveau-né.