Abstract
Oxygen therapy is seldom recommended in infants with cyanotic congenital heart disease (CCHD) because of the small change in PaO2 that occurs with increased inspired oxygen concentrations. Arterial PO2 was measured in 25 infants with CCHD and C02 production (VC02) in 17 of them while breathing 21 and 100% 02. Pa02 increased from 31±7.9 to 41.4±17.3 mmHg within 3 minutes of breathing 100% 02. (P<0.001) This determined an increase in 02 content of 12 to 20%, depending on the initial Pa02 and the position of the Hb-O2 dissociation curve. Although the change in PaO2 was small, the increase in O2 content was considerable because it occurred in the steep part of the Hb-O2 dissociation curve.
The increase in PaO2 cannot be explained solely by an increase in dissolved O2 in the blood perfusing the lungs but must be related to either an increase in pulmonary blood flow or to an increase in 02 saturation of the pulmonary venous blood. The latter would occur in case of an increased A/aO2 gradient due to co-existing pulmonary pathology. VCO2 increased from 7.6 before to 8.5 ml/minxkg 30 minutes after breathing 100% O2 (P< 0.005). This increase indicates that the basal metabolic rate may be depressed in infants with severe chronic hypoxemia and this can be at least partially reversed by a small increase in PaO2. These results suggest that 02 therapy may improve tissue oxygenation in some infants with CCHD.
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Gerhardt, T., Bancalari, E. 112 INCREASED OXYGENATION IN INFANTS WITH CANOTIC CONGENITAL HEART DISEASE DURING EXPOSURE TO 100% 02. Pediatr Res 12 (Suppl 4), 382 (1978). https://doi.org/10.1203/00006450-197804001-00117
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DOI: https://doi.org/10.1203/00006450-197804001-00117
