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Spontaneous versus controlled ventilation in anaesthetized children with congenital cardiac malformations
Author(s) -
Olsson A.K.,
Lindahl S. G. E.
Publication year - 1987
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1987.tb02526.x
Subject(s) - medicine , ventilation (architecture) , shunt (medical) , anesthesia , controlled ventilation , mechanical ventilation , perfusion , cardiology , mechanical engineering , engineering
The effects of intermittent positive pressure ventilation on gas exchange were studied in 12 children with congenital cardiac malformation. Six children (b.w. 3.7–16 kg) had a left‐to‐right shunt (Group LR) resulting in overperfused lungs, while six others (b.w. 3.4–12 kg) had a right‐to‐left shunt (Group RL) with oligaemic lungs. Measurements, prior to surgery, were done during spontaneous breathing (SB) and controlled mechanical ventilation (CMV) with a short (25%) and a long (55%) duration of inspiration. In children with oligaemic lungs P (a‐E) co 2 differences and V D /V T ratios were greater and Pao 2 was lower than in those with overperfused lungs, indicating a less efficient ventilation. In Group RL, ventilation and gas exchange during SB were similar at the two settings of CMV. In Group LR, however, V D /V T was reduced during CMV, with the lowest V D /V T ratio at the longer inspiration time. It is concluded that in children with an oligaemic lung perfusion, either of the two ventilator settings could be used. When controlled ventilation is to be used in children with overperfused lungs, the longer duration of inspiration seems to be preferable.