BACKGROUND Although balloon pulmonary angioplasty (BPA) improves the hemodynamics and prognosis of patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH), the mechanisms of improvement in oxygenation remain to be elucidated. METHODSANDRESULTS From August 2013 to May 2015, we performed a total of 113 BPA procedures in 24 patients with inoperable CTEPH (mean 4.7 procedur...

Concern has been raised that altering the fraction of inspired O₂ (Fi(O₂)) could accelerate or decelerate microbubble dissolution time within the pulmonary vasculature and thereby invalidate the ability of saline contrast echocardiography to detect intrapulmonary arteriovenous shunt in subjects breathing either a low or a high Fi(O₂). The present study determined whether the gaseous component u...

Purpose: To investigatge right-to-left shunt determination in dog lungs under inhalantion anesthesia with non-rebreathing and rebreathing systems and fraction of inspired oxygen (FIO2) of 0.9 and 0.4, respectively. Methods: Two groups of 10 dogs each under inhalation anesthesia with sevoflurane: GI in which it was utilized non-rebreathing semiclosed system and FIO2 = 0.9, and GII in which it wa...

background : hepatopulmonary syndrome (hps) refers to arterial hypoxemia caused by pulmonary vasodilation, which is a consequence of portal hypertension. hps is associated with increased morbidity and mortality; thus, it is important to diagnose this entity as soon as possible for treatment to be administered. materials and methods: in a cross-sectional study, 40 children (6 months to 14 years ...

Liver cirrhosis is sometimes associated with very severe hypoxaemia, which is thought to be the result of intrapulmonary vascular dilatations (IPVDs). These vascular abnormalities, although close to the gas exchange units, are so dilated that diffusion of oxygen molecules to their centre is impaired, causing an increase in alveolar-arterial oxygen tension difference (P(A-a)O2). On the other han...

Balloon or coil embolization has become established therapy for multiple PAVMs. We were able to evaluate a 32-year-old woman with multiple PAVMs characterized by significant orthodeoxia, intrapulmonary shunt, dyspnea and limited exercise tolerance before and after balloon and coil embolization. After embolization of three of her largest PAVMs, repeat evaluation revealed improvement in her sympt...

OBJECTIVE To evaluate the extent of intrapulmonary right to left shunting in children after bidirectional cavopulmonary anastomosis (BCPA). DESIGN Prospective study of patients who underwent BCPA in a single centre. PATIENTS 17 patients with complex cyanotic congenital cardiac malformations who underwent BCPA at 1-45 months of age (median 21 months) were evaluated 15-64 months postoperative...

Students in the Medical College of Georgia Nursing Anesthesia Program, Augusta, Ga, use human patient simulation as an avenue for advanced education. Software drives the simulation model through a myriad of programmed patient scenarios. Individually controlled physiologic variables help students understand how to manage a critically ill patient. Similar technology provides students the opportun...

Hepatopulmonary syndrome (HPS) is a complication of liver disease. It is most frequently related to portal hypertension (with or without cirrhosis), although chronic liver disease of almost any etiology could be related to HPS (1, 2). Moreover, some acute liver diseases are related to HPS, such as ischemic hepatitis (3). HPS can be diagnosed when the following disorders have been approved (1, 4...

STUDY OBJECTIVES To assess the reliability of new and traditional oxygenation measurements in reflecting intrapulmonary shunt. DESIGN Prospective study. SETTING Cardiac surgery unit at a university hospital. PATIENTS Fifty-five patients undergoing coronary artery bypass grafting. MEASUREMENTS AND RESULTS Simultaneous blood samples were collected from an indwelling arterial line and a ca...