{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T19:51:04Z","timestamp":1775073064205,"version":"3.50.1"},"reference-count":16,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2001,5,14]]},"published-print":{"date-parts":[[2001,9,1]]},"abstract":"<jats:sec>\n                  <jats:title>AIMS<\/jats:title>\n                  <jats:p>To make non-invasive measurements of right to left (R-L) shunt and reduced ventilation\/perfusion ratio (V<jats:sub>A<\/jats:sub>\/Q) in neonates with pulmonary failure and to examine sequential changes in these variables after treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec sec-type=\"methods\">\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Twelve neonates with pulmonary failure were studied. They ranged in gestational age from 24 to 37 (median 27) weeks and were 1\u201339 (median 4) days old. Shunt and reduced V<jats:sub>A<\/jats:sub>\/Q were derived from their effects on the relation between inspired oxygen pressure (P<jats:sc>io<jats:sub>2<\/jats:sub>\n                     <\/jats:sc>) and arterial oxygen saturation measured with a pulse oximeter (Sp<jats:sc>o<\/jats:sc>\n                     <jats:sub>2<\/jats:sub>). Pairs of P<jats:sc>io<jats:sub>2<\/jats:sub>\n                     <\/jats:sc> \n                     <jats:italic>v<\/jats:italic>Sp<jats:sc>o<\/jats:sc>\n                     <jats:sub>2<\/jats:sub> data points were obtained by varying P<jats:sc>io<jats:sub>2<\/jats:sub>\n                     <\/jats:sc> in a stepwise fashion. A computer algorithm based on a model of pulmonary gas exchange fitted a curve to these data. With P<jats:sc>io<jats:sub>2<\/jats:sub>\n                     <\/jats:sc> on the abscissa, an increase in shunt produced a downward movement of the curve, whereas reducing V<jats:sub>A<\/jats:sub>\/Q to &lt;\u20090.8 shifted the curve to the right. The right shift gives a variable that is inversely related to V<jats:sub>A<\/jats:sub>\/Q, the P<jats:sc>io<jats:sub>2<\/jats:sub>\n                     <\/jats:sc>\u2009\u2212\u2009P<jats:sub>c\u0304<\/jats:sub>\n                     <jats:sc>o<\/jats:sc>\n                     <jats:sub>2<\/jats:sub>difference, where P<jats:sub>c\u0304<\/jats:sub>\n                     <jats:sc>o<\/jats:sc>\n                     <jats:sub>2<\/jats:sub> is mixed capillary oxygen pressure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Ten of the 12 infants on the first study day had large shunts (range 5.9\u201331.0%, median 19.9%, normal &lt;\u20098%) and large P<jats:sc>io<jats:sub>2<\/jats:sub>\n                     <\/jats:sc>\u2009\u2212\u2009P<jats:sub>c\u0304<\/jats:sub>\n                     <jats:sc>o<\/jats:sc>\n                     <jats:sub>2<\/jats:sub>differences (range 9.7\u201364.4 kPa, median 19.8 kPa, normal &lt;\u20097 kPa) equivalent to a median V<jats:sub>A<\/jats:sub>\/Q of 0.2 (normal median V<jats:sub>A<\/jats:sub>\/Q\u2009=\u20090.8). Sequential improvement in shunt and V<jats:sub>A<\/jats:sub>\/Q were shown in most infants after treatment. Sudden large changes in these variables were shown in two infants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSION<\/jats:title>\n                  <jats:p>This simple non-invasive method distinguishes between shunt and reduced V<jats:sub>A<\/jats:sub>\/Q in neonates with pulmonary failure.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/fn.85.2.f127","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T06:37:59Z","timestamp":1027751879000},"page":"F127-F132","source":"Crossref","is-referenced-by-count":32,"title":["Non-invasive assessment of shunt and ventilation\/perfusion ratio in neonates with pulmonary failure"],"prefix":"10.1136","volume":"85","author":[{"given":"H L","family":"Smith","sequence":"first","affiliation":[{"name":"Cambridge University Department of Anaesthesia, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J G","family":"Jones","sequence":"additional","affiliation":[{"name":"Cambridge University Department of Anaesthesia, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2001,9,1]]},"reference":[{"key":"2025090514552964000_85.2.F127.1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/71.4.488"},{"key":"2025090514552964000_85.2.F127.2","doi-asserted-by":"crossref","first-page":"497P","DOI":"10.1093\/bja\/61.4.497","article-title":"Predicting changes in oxygen saturation using pulse oximetry.","volume":"61","author":"Sapsford","year":"1988","journal-title":"Br J Anaesth"},{"key":"2025090514552964000_85.2.F127.3","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.161.1.9812017"},{"key":"2025090514552964000_85.2.F127.4","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1152\/jappl.1974.36.1.74","article-title":"Ventilation-perfusion relationships as assessed by aADN2 in hyaline membrane disease.","volume":"36","author":"Corbet","year":"1974","journal-title":"J Appl Physiol"},{"key":"2025090514552964000_85.2.F127.5","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950090404"},{"key":"2025090514552964000_85.2.F127.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(67)80006-4"},{"key":"2025090514552964000_85.2.F127.7","doi-asserted-by":"publisher","DOI":"10.1136\/thx.49.8.815"},{"key":"2025090514552964000_85.2.F127.8","doi-asserted-by":"publisher","DOI":"10.1136\/thx.49.12.1251"},{"key":"2025090514552964000_85.2.F127.9","first-page":"375","article-title":"The PiO2 vs. SpO2 diagram: a non-invasive measure of pulmonary oxygen exchange.","volume":"12","author":"Sapsford","year":"1995","journal-title":"Eur J Anaesth"},{"key":"2025090514552964000_85.2.F127.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1997.153-az0159.x"},{"key":"2025090514552964000_85.2.F127.11","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.1998.00297.x"},{"key":"2025090514552964000_85.2.F127.12","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/S0140-6736(88)92418-X","article-title":"Cotside measurement of cerebral blood flow in infants by near infrared spectroscopy.","volume":"2","author":"Edwards","year":"1988","journal-title":"Lancet"},{"key":"2025090514552964000_85.2.F127.13","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/56.12.1325"},{"key":"2025090514552964000_85.2.F127.14","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/74.5.538"},{"key":"2025090514552964000_85.2.F127.15","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2346.1997.00135.x"},{"key":"2025090514552964000_85.2.F127.16","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198709001-00551"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/fn.85.2.F127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T22:25:14Z","timestamp":1757111114000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/fn.85.2.F127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,9,1]]},"references-count":16,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2001,9,1]]},"published-print":{"date-parts":[[2001,9,1]]}},"alternative-id":["10.1136\/fn.85.2.F127"],"URL":"https:\/\/doi.org\/10.1136\/fn.85.2.f127","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"value":"1359-2998","type":"print"},{"value":"1468-2052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,9,1]]}}}