All issues > Volume 34(6); 1991

Original Article

J Korean Pediatr Soc. 1991;34(6):787-795. Published online June 30, 1991.

Acute hemodynamic effects of increasing hemoglobin concentration in children with congenital heart disease and relative anemia.

You In Park¹, Young You¹, Chang Sung Son¹, Joo Won Lee¹, Young Chang Tocko¹

¹Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea

Received: September 29, 1990;  Accepted: December 24, 1990.

Abstract

The short-term effects of increasing hemoglobin concentration were evaluated on cardiac catheter- ization in nine patients with congenital heart diseases and relative anemia. Diagnosis were ventricular septal defect in six, tetralogy of Fallot in two, and endocardial cushion defect in one. Various hemodynamic data including pulmonary and systemic blood flow, pulmonary and systemic vascular resistance and the degree of shunt were compared before and 20 minutes after isovolemic partial exchange transfusion with 20 ml/kg packed red cells. The results were as follows: I. In six patients with left to right shunt who had ventricular septal defects, 1) the pulmonary blood flow (Qp) and systemic blood flow (Qs) decreased after partial isovolemic exchange transfusion (p<0.05). 2) the pulmonary vascular resistance (Rp) and systemic vascular resistance (Rs) increased after partial isovolemic exchange transfusion, but there was no statistical significance(p > 0.05). 3) the volume of left to right shunt decreased after partial isovolemic exchange transfusion (p<0. 01). II. In two patients with right to left shunt who had Tetralogy of Fallot, and one with bi-diretional shunt who had endocardial cushion defect with predominnt right to left shunt due to pulmonary hypertension. 1) the pulmonary blood flow (Qp) and systemic blood flow (Qs) decreased after partial isovolemic exchange transfusion, but there was no ststistical significance (p>0.05). 2) the pulmonary vascular resistance (Rp) decreased insignificantly (p>0.05), but systemic vascular resistance (Rs) increased significantly after partial isovolemic exchange transfusion (p<0.05). 3) the amount of right to left shunt decreased after partial isovolemic exchange transfusion, but it • was considered insignificant(p > 0.05).

Keywords :Pulmonary and systemic blood flow;Pulmonary and systemic vascular resistance;Amount of shunt;Partial isovolemic exchange