Abstract
To manage pediatric ventilation in children with congenital heart disease, the knowing of the many differences from adult respiratory system is not enough.
In fact, into the wide contest of pediatric cardiac defect, lung and cardiac systems work affecting continuously their function. Any interventions designed to improve the function of one system may lead to unwanted effects on another. For these reasons, to have an optimal manage on this interaction, a thorough understanding of respiratory mechanics, patient-ventilator interactions, intrapulmonary gas exchange mechanisms, hemodynamics under physiologic and pathophysiologic conditions, and a complete knowledge of the procedures are therefore required and mandatory.
In this chapter are summarized the bases of the respiratory system in pediatric patients, the physiology of cardiopulmonary interaction, the principal respiratory support methods, and finally the specific considerations for each pathological cardiopulmonary interaction.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsNotes
- 1.
Inspiration time (IT) sec: neonates, 0.4; infants, 0.6; child, 0.7; adolescent and adult, 0.9.
References
Michard F, Teboul JL. Using heart-lung interactions to assess fluid responsiveness during mechanical ventilation. Crit Care. 2000;4:282–9.
Shekerdemian L, Bohn D. Cardiovascular effects of mechanical ventilation. Arch Dis Child. 1999;80:475–80.
Pinsky MR. Determinant of pulmonary flow variation during respiration. J Appl Physiol. 1984;56:1237–45.
Venus B, Cohen LE, Smith RA. Hemodynamics and intrathoracic pressure transmission during controlled mechanical ventilation and positive end-expiratory pressure in normal and low compliant lungs. Crit Care Med. 1988;16:686–90.
West J, Dollery C, Naimark A. Distribution of blood flow in isolated lung; relation to vascular and alveolar pressures. J Appl Physiol. 1964;19:713–24.
Sommer N, Dietrich A, Schermuly RT, Ghofrani HA, Gudermann T, Schulz R, Seeger W, Grimminger F, Weissmann N. Regulation of hypoxic pulmonary vasoconstriction: basic mechanisms. Eur Respir J. 2008;32:1639–51.
Thiene G, Frescura C. Anatomical and pathophysiological classification of congenital heart disease. Cardiovasc Pathol. 2010;19:259–74.
Mayfield S, Jauncey-Cooke J, Hough JL, Schibler A, Gibbons K, Bogossian F. High-flow nasal cannula therapy for respiratory support in children. Cochrane Database Syst Rev. 2014;(3):CD009850.
Lee JH, Rehder KJ, Williford L, Cheifetz IM, Turner DA. Use of high flow nasal cannula in critically ill infants, children, and adults: a critical review of the literature. Intensive Care Med. 2013;39:247–57.
Caliumi-Pellegrini G, Agostino R, Orzalesi M, Nodari S, Marzetti G, Savignoni PG, Bucci G. Twin nasal cannula for administration of continuous positive airway pressure to newborn infants. Arch Dis Child. 1974;49:228.
Rotta AT, de Carvalho WB. Mechanical ventilation following cardiac surgery in children. Curr Respir Med Rev. 2012;8(1):44–52.
Bradley SM, Simsic JM, Mulvihill DM. Hyperventilation impairs oxygenation after bidirectional superior cavopulmonary connection. Circulation. 1998;98:II372–6; discussion II6–7
Bradley SM, Simsic JM, Mulvihill DM. Hypoventilation improves oxygenation after bidirectional superior cavopulmonary connection. J Thorac Cardiovasc Surg. 2003;126:1033–9.
Gamillscheg A, Zobel G, Urlesberger B, et al. Inhaled nitric oxide in patients with critical pulmonary perfusion after Fontan-type procedures and bidirectional Glenn anastomosis. J Thorac Cardiovasc Surg. 1997;113:435–42.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Isgrò, G., Silvetti, S. (2019). Respiratory System and Mechanical Ventilation in Patients with CHD. In: Flocco, S., Lillo, A., Dellafiore, F., Goossens, E. (eds) Congenital Heart Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-78423-6_9
Download citation
DOI: https://doi.org/10.1007/978-3-319-78423-6_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-78421-2
Online ISBN: 978-3-319-78423-6
eBook Packages: MedicineMedicine (R0)