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  • Title: [Simultaneous assessment of intra-pulmonary right-to-left shunting and of aADCO2 in 5 neonates with refractory hypoxemia (author's transl)].
    Author: Dehan M, Guenard H, Hernandorena X, Janaud JC, Boulley AM, Laudignon N, Ropert JC, Gabilan JC.
    Journal: Arch Fr Pediatr; 1981 Feb; 38(2):101-7. PubMed ID: 7235826.
    Abstract:
    Five neonates with refractory hypoxemia (aortic PO2 less than or equal to 6.7 KPa despite FiO2 = 1 and efficient artificial ventilation) were investigated in order to determine the principal mechanism of hypoxemia. PO2 values were measured (under FiO2 = 1) in a pulmonary vein, the left auricle and the aorta. They were used to distinguish intra-pulmonary shunts from extra-pulmonary shunts (though foramen ovale and/or ductus arteriosus). Simultaneous measurements of PACO2 and PaCO2 were used to assess the percentage of the ventilation output reaching hypoperfused areas. In cases with extra-pulmonary shunt, when this percentage is over 30%, pulmonary hypertension is likely. The use of both methods is useful for selecting those patients who might benefit from tolazoline.
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