Abstract
Objective. To identify criteria for reducing of the systemic blood flow (low cardiac output syndrome) in newborns with parallel circulation
based on changes in the gas analyzes of arterial and central venous blood.
Material and methods. A retrospective investigation of arterial and central venous blood gas analyzes in the postoperative period in
newborns with parallel blood circulation, depending on the signs of impaired systemic perfusion, was carried out. A total of
125 patients and 670 pairs of laboratory results were selected for presentation to the study. 84 samples from 52 children met the
inclusion criteria.
Results and discussion. It was revealed that the following indicators may be markers of systemic hypoperfusion in patients with
single-ventricular physiology: SvO2 is below 44.5% (sensitivity 83%, specificity 46%, accuracy 60% at χ2=6, p=0.02); PvO2
below 26 mm Hg (sensitivity 74%, specificity 56%, accuracy 66% with χ2=7.6, p=0.004); CvO2 is lower than 119 ml/l (sensitivity
83%, specificity 72%, accuracy 78%, with χ2=25, p=0.001); O2ER is above 20% (sensitivity 76%, specificity 89%, accuracy
90% with χ2=23, p=0.001); dPCO2 is higher than 5.4 mm Hg (sensitivity 90.6%, specificity 87.1%, accuracy 89% with χ2=50,
p=0.001).
Conclusions. Reduction in systemic blood flow in newborns with single-ventricular hemodynamics is accompanied by characteristic
changes of the PvO2, SvO2, CvO2, O2ER, dPCO2, dPh. The most sensitive markers are CvO2, O2ER and dPCO2. For newborns
with single ventricle hemodynamics, the following laboratory signs of a normal systemic flow can be determined: PvO2 is more than
26 mm Hg; SvO2 more than 55 mm Hg; CvO2 more than 119 ml/l; O2ER less than 19%; dPCO2 less than 3 mm Hg, dPh less than
0.04.
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About the authors
- Gennadiy G. Khubulava, Dr Med. Sc., Academician of RAS, Chief of Chair, orcid.org/0000-0001-8873-7071;
-
Aleksey B. Naumov, Cand. Med. Sc., Associate Professor, rcid.org/0000-0003-0323-0162;
-
Sergey P. Marchenko, Dr Med. Sc., Professor, orcid.org/0000-0003-4785-4532;
-
Ol'ga Yu. Chupaeva, Anesthesiologist-Intensivist, orcid.org/0000-0003-4204-6915;
-
Anastasiya A. Seliverstova, Cardiologist, Ultrasonic Diagnostician, orcid.org/0000-0003-2992-2255;
-
Nikolay G. Pilyugov, Head of Department, orcid.org/0000-0002- 5905-683X;
-
Ol'ga Yu. Tereshenko, Anesthesiologist-Intensivist, orcid.org/0000-0003-4629-1061;
-
Yuriy S. Aleksandrovich, Dr Med. Sc., Professor, Pro-rector, Chief of Chair, orcid.org/0000-0002-2131-4813;
-
Konstantin V. Pshenisnov, Cand. Med. Sc., Associate Professor, Anesthesiologist-Intensivist, orcid.org/0000-0003-1113-5296;
-
Liliya L. Popova, Cardiologist, orcid.org/0000-0003- 0622-8367;
-
Mikhail S. Andreev, Senior Laboratory Assistant, orcid.org/0000-0002-4700-0265;
-
Oksana V. Nevmerzhitskaya, Cand. Med. Sc., Deputy Chief Physician, orcid.org/0000-0002-3993-6899
