title: Estimating intracardiac and extracardiac shunting in the setting of complex congenital heart disease.
abstract: Complex congenital heart disease (CHD) is associated with significant morbidity worldwide. Managing hypoxemia in these populations can be difficult, particularly in the setting of cyanotic CHD. However, the presence of additional extracardiac shunts secondary to acute respiratory disease can be very challenging to manage. Before understanding how to deal with hypoxemia in patients with dual shunts, one needs to understand the physiology and diagnosis related to the individual shunts and apply this knowledge to the patient as a whole.
authors.affiliation: Department of Pediatric Critical Care, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Stark
authors.affiliation: Department of Pediatric Critical Care, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Lara S
authors.initials: LS
authors.lastname: Shekerdemian
keywords: Congenital heart disease; pulmonary; shunts