Original ArticlesPhenoxybenzamine improves systemic oxygen delivery after the Norwood procedure1
Section snippets
Material and methods
To determine the effect of the α-blocker POB on the outcome of patients undergoing the Norwood procedure, we analyzed the outcome of 15 consecutively seen patients who underwent the Norwood procedure between July 1996 and April 1997 at the Children’s Hospital of Wisconsin. The start date of inclusion was selected to coincide with the routine placement of 4-French intravascular optical catheters (Abbott Laboratories, North Chicago, IL) directly into the superior vena cava at the time of
Results
Preoperative and operative patient characteristics are summarized in Table 1. There was a borderline statistically significant difference (p = 0.06) in weight between the two groups. Shunt size, normalized as a ratio of either diameter or cross-sectional area to body weight, was not significantly different. Associated congenital anomalies included proximal esophageal atresia with a distal tracheoesophageal fistula combined with a diaphragmatic hernia in 1 patient and congenital complete heart
Comment
An imbalance between pulmonary and systemic flow with excessive pulmonary flow at the expense of systemic oxygen delivery is a common scenario after the Norwood procedure that can lead to death [1]. Arterial oxygen saturation and arterial blood gas analysis combined with physical assessment has been used as a guide to achieve a balanced Qp/Qs [8]. An SaO2 of 75% to 80% has been thought to indicate a Qp/Qs of approximately 1, representing equal contributions of systemic and pulmonary venous
Acknowledgements
We are grateful for the outstanding care provided to the patients in this study by the nursing staffs of the pediatric and neonatal intensive care units of the Children’s Hospital of Wisconsin.
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