Restrictive Ventilatory Impairment and Arterial Oxygenation Characterize Rest and Exercise Ventilation in Patients After Fontan Operation

H. Ohuchi; H. Ohashi; H. Takasugi; O. Yamada; T. Yagihara; S. Echigo

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Restrictive Ventilatory Impairment and Arterial Oxygenation Characterize Rest and Exercise Ventilation in Patients After Fontan Operation

机译：丰坦手术后患者的限制性通气障碍和动脉氧合特征是休息和运动通气

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The objective of this study was evaluate the relationships between abnormal pulmonary circulation, lung function, and respiratory response during exercise in Fontan patients. Pulmonary function and cardiopulmonary exercise tests were performed in 101 Fontan patients and 122 controls. A small vital capacity (VC) with a high residual volume-to-total lung capacity ratio and a slight but significant low arterial saturation with hypocapnia were observed in Fontan patients. The number of surgical procedures determined VC. Total cavopulmonary connection, fenestration, higher pulmonary arterial wedge pressure, and smaller VC were independent determinants of low arterial saturation, which was the only determinant of hypocapnia. Arterial saturation decreased during exercise and resting arterial saturation correlated with that at peak exercise. Improvement in dead space ventilation was less in Fontan patients and was independently determined by resting arterial saturation. A steeper minute ventilation–carbon dioxide production slope was determined by resting arterial saturation, arterial carbon dioxide tension, and peak oxygen uptake. In Fontan patients, in addition to dead space ventilation, surgery-related reduced VC, the type of repair, and high pulmonary arterial wedge pressure cause arterial desaturation with subsequent hypocapnia, resulting in accelerated inefficient ventilation at rest and during exercise.

机译：这项研究的目的是评估Fontan患者运动过程中异常肺循环，肺功能和呼吸系统反应之间的关系。在101名Fontan患者和122名对照中进行了肺功能和心肺运动测试。在Fontan患者中观察到较小的肺活量（VC），具有高的残余体积与肺总容量之比，以及轻度但轻度但明显但低的动脉低饱和度。确定VC的外科手术次数。总的心肺连接，开窗，较高的肺动脉楔压和较小的VC是低动脉饱和的独立决定因素，这是低碳酸血症的唯一决定因素。运动期间动脉饱和度降低，而静息动脉饱和度与运动高峰时的饱和度相关。 Fontan患者死腔通气的改善较少，其取决于静息动脉饱和度。通过静止的动脉饱和度，动脉二氧化碳张力和峰值摄氧量来确定更陡峭的分钟通气量-二氧化碳产生斜率。在Fontan患者中，除死腔通气外，与手术有关的VC降低，修复类型和高肺动脉楔压会导致动脉血氧饱和度降低，并继而引起低碳酸血症，从而导致休息和运动时通气效率降低。

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《Pediatric Cardiology》 |2004年第5期|513-521|共9页
作者
H. Ohuchi; H. Ohashi; H. Takasugi; O. Yamada; T. Yagihara; S. Echigo;
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作者单位

Department of Pediatrics National Cardiovascular CenterPhysiological Imaging Labratory;

Department of Pediatrics National Cardiovascular Center;

Department of Pediatrics National Cardiovascular Center;

Department of Pediatrics National Cardiovascular Center;

Department of Thoracic surgery National Cardiovascular Center;

Department of Pediatrics National Cardiovascular Center;

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正文语种 eng
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关键词
Fontan procedure; Hypoxia; Hypocapnia; Exercise; Ventilation;

机译：方丹手术;低氧;低碳酸血症;运动;通风;

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1. Restrictive ventilatory impairment and arterial oxygenation characterize rest and exercise ventilation in patients after fontan operation. [J] . Ohuchi H, Ohashi H, Takasugi H, Pediatric cardiology . 2004,第5期

机译：font门手术后患者的休息和运动通气是限制性通气障碍和动脉氧合的特征。
2. A restrictive ventilatory pattern is common in patients with univentricular heart after Fontan palliation and associated with a reduced exercise capacity and quality of life [J] . Callegari Alessia, Neidenbach Rhoia, Milanesi Ornella, Congenital heart disease. . 2019,第2期

机译：限制性通气模式在短纳姑娘姑息后的小心心脏患者中是常见的，并且与减少的运动能力和生活质量相关联
3. The Importance of the Muscle and Ventilatory Blood Pumps During Exercise in Patients Without a Subpulmonary Ventricle (Fontan Operation) [J] . Keri M. Shafer, Jorge A. Garcia, Tony G. Babb, Journal of the American College of Cardiology . 2012,第20期

机译：没有亚流心室的患者运动过程中肌肉和通风血液泵的重要性（Fontan操作）
4. AN AUTOMATED SIMULATION PROTOCOL FOR EXERCISE PHYSIOLOGY IN FONTAN PATIENTS USING A CLOSED-LOOP LUMPED-PARAMETER MODEL [C] . Ethan Kung, Alessandro Giardini, Francesco Migliavacca, ASME bioengineering conference . 2014

机译：基于闭环集总模型模型的丰坦病患者运动生理学自动模拟协议
5. Post-operative Ventilation Patterns and the Effects of Non-invasive Positive Pressure Therapy on Ventilatory Changes as Measured by a Non-invasive Impedance Device in Patients with Obstructive Sleep Apnea [D] . Chabo, Travis L. 2019

机译：术后通风模式和非侵入性阳性压力治疗对阻塞性睡眠呼吸暂停患者无侵入阻抗装置测量的通气变化的影响
6. The Importance of the Muscle and Ventilatory Blood Pumps During Exercise in Patients Without a Subpulmonary Ventricle (Fontan Operation): Author Response [O] . Keri M. Shafer, Jorge A. Garcia, Tony G. Babb, -1

机译：肌肉通气血液的重要性和泵患者的运动过程中如果没有肺动脉瓣下心室（Fontan手术）：作者回应
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Restrictive Ventilatory Impairment and Arterial Oxygenation Characterize Rest and Exercise Ventilation in Patients After Fontan Operation

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