Background and Aims Major challenge for treatment of Hypoplastic left heart syndrome by Norwood procedure is in achieving the adequate Qp/Qs value. The absence of routine method of assessing the Qp/Qs value can lead to hypoxia, brain injury, for Qp/Qs< < 1 or to insufficient tissue perfusion and lung edema for Qp/Qs>>1. The aim of the study was to develop routine method for Qp/Qs assessment for PICU and NICU patients.
Method development: A mathematical model of indicator movement for SV anatomy was developed. After intravenous injection and mixing in SV the first portion of the indicator enters systemic circulation via aorta. Second portion of the indicator enters lungs via PA, then again enters SV via left atria etc. The model suggests that Qp/Qs may be calculated from dilution curve (Pic.1) Qp/Qs=S2/S1.
Results COstatus monitor, (Transonic Systems Inc., NY, USA) was used in NICU and PICU patients to measures cardiac output, blood volumes and to identify shunts and PDA. According to Transonic curve data archive recoded by COstatus for single ventricle patients the actual shape of dilution curves (example, Pic.2) well agrees with model data.
Conclusions Mathematical model for indicator movement in SV anatomy proved that Qp/Qs value can be calculated from indicator dilution curve. Next step is to validate the Qp/Qs values measured by COstatus in animal model and in patients.
Grant NIH SBIR # R43 HL111852–01.
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