title: Coupling of central venous pressure and intracranial pressure in a 6-year-old patient with fontan circulation and intracranial hemorrhage.
abstract: A sharp rise in intracranial pressure (ICP) was noted in a 6-year-old girl with Fontan circulation after surgical removal of a hematoma associated with intracranial hemorrhage. Inhalation of nitric oxide resulted in reduction of central venous pressure (CVP) and precipitous fall in ICP, which was otherwise resistant to conventional therapy. Specifically, the rate of fall of ICP (9 mm Hg) exceeded that of the CVP (3 mm Hg), indicating disproportionate CVP-ICP coupling. The present case provides not only a novel insight into cardio-cerebral interaction in Fontan physiology but also useful information regarding the treatment of Fontan patients in the setting of increased ICP.
authors.affiliation: Department of Pediatrics and Pediatric Cardiology, Saitama Medical University, Saitama, Japan.
authors.forename: Clara
authors.initials: C
authors.lastname: Kurishima
authors.forename: Masayo
authors.initials: M
authors.lastname: Tsuda
authors.forename: Yuko
authors.initials: Y
authors.lastname: Shiima
authors.forename: Masashi
authors.initials: M
authors.lastname: Kasai
authors.forename: Seiki
authors.initials: S
authors.lastname: Abe
authors.forename: Jun
authors.initials: J
authors.lastname: Ohata
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shigeta
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasukochi
authors.forename: Masanori
authors.initials: M
authors.lastname: Tamura
authors.forename: Hideaki
authors.initials: H
authors.lastname: Senzaki
mesh_terms: D000280:Administration, Inhalation; D002496:Central Venous Pressure / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure / Q000009:adverse effects* / Q000379:methods; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D019586:Intracranial Hypertension / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D009569:Nitric Oxide / Q000627:therapeutic use*; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D009569:Nitric Oxide