{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:32:47Z","timestamp":1783528367173,"version":"3.55.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T00:00:00Z","timestamp":1570579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T00:00:00Z","timestamp":1570579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University","award":["Zy2016101"],"award-info":[{"award-number":["Zy2016101"]}]},{"name":"Taipei Cheng Hsin General Hospital","award":["CHGH105-1"],"award-info":[{"award-number":["CHGH105-1"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n              <jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Increase of pulmonary vascular resistance (PVR) is an efficient method of modulating pulmonary and systemic blood flows (Qp\/Qs) for patients with left-to-right (L-R) shunt, and is also closely associated with insufficient oxygen exchange for pulmonary hypoperfusion. So that it might be a preferred regime of maintaining arterial partial pressure of carbon dioxide tension (PaCO<jats:sub>2<\/jats:sub>) within an optimal boundary via ventilation management in congenital heart disease (CHD) patients for the inconvenient measure of the PVR and Qp\/Qs. However, the appropriate range of PaCO<jats:sub>2<\/jats:sub> and patient-specific mechanical ventilation settings remain controversial for CHD children with L-R shunt.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Thirty-one pediatric patients with L-R shunt, 1\u20136\u2009yr of age, were included in this observation study. Patients were ventilated with tidal volume (V<jats:sub>T<\/jats:sub>) of 10, 8 and 6\u2009ml\/kg in sequence, and 15\u2009min stabilization period for individual V<jats:sub>T<\/jats:sub>. The velocity time integral (VTI) of L-R shunt, pulmonary artery (PA) and descending aorta (DA) were measured with transesophageal echocardiography (TEE) after an initial 15\u2009min stabilization period for each V<jats:sub>T<\/jats:sub>, with arterial blood gas analysis. Near-infrared spectroscopy sensor were positioned on the surface of the bilateral temporal artery to monitor the change in regional cerebral oxygen saturation (rScO<jats:sub>2<\/jats:sub>).<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>PaCO<jats:sub>2<\/jats:sub> was 31.51\u2009\u00b1\u20090.65\u2009mmHg at V<jats:sub>T<\/jats:sub> 10\u2009ml\/kg vs. 37.15\u2009\u00b1\u20090.75\u2009mmHg at V<jats:sub>T<\/jats:sub> 8\u2009ml\/kg (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.03), with 44.24\u2009\u00b1\u20090.99\u2009mmHg at V<jats:sub>T<\/jats:sub> 6\u2009ml\/kg significantly higher than 37.15\u2009\u00b1\u20090.75\u2009mmHg at V<jats:sub>T<\/jats:sub> 8\u2009ml\/kg. However, PaO<jats:sub>2<\/jats:sub> at a V<jats:sub>T<\/jats:sub> of 6\u2009ml\/kg was lower than that at a V<jats:sub>T<\/jats:sub> of 10\u2009ml\/kg (<jats:italic>P<\/jats:italic>\u2009=\u20090.05). Meanwhile, 72% (22\/31) patients had PaCO<jats:sub>2<\/jats:sub> in the range of 40-50\u2009mmHg at V<jats:sub>T<\/jats:sub> 6\u2009ml\/kg. VTI of L-R shunt and PA at V<jats:sub>T<\/jats:sub> 6\u2009ml\/kg were lower than that at V<jats:sub>T<\/jats:sub> of 8 and 10\u2009ml\/kg (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). rScO<jats:sub>2<\/jats:sub> at a V<jats:sub>T<\/jats:sub> of 6\u2009ml\/kg was higher than that at a V<jats:sub>T<\/jats:sub> of 8 and 10\u2009ml\/kg (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), with a significantly correlation between rScO<jats:sub>2<\/jats:sub> and PaCO<jats:sub>2<\/jats:sub> (r\u2009=\u20090.53). VTI of PA in patients with defect diameter\u2009&gt;\u200910\u2009mm was higher that that in patients with defect diameter\u2009\u2264\u200910\u2009mm.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Maintaining PaCO<jats:sub>2<\/jats:sub> in the boundary of 40-50\u2009mmHg with V<jats:sub>T<\/jats:sub> 6\u2009ml\/kg might be a feasible ventilation regime to achieve better oxygenation for patients with L-R shunt. Continue raising PaCO<jats:sub>2<\/jats:sub> should be careful.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Trail registration<\/jats:title>\n                <jats:p>Clinical Trial Registry of China (http:\/\/www.chictr.org.cn) identifier: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.chictr.org.cn\/showproj.aspx?proj=19321\">ChiCTR-OOC-17011338<\/jats:ext-link>, prospectively registered on May 9, 2017.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12871-019-0852-1","type":"journal-article","created":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T11:05:22Z","timestamp":1570619122000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The effects of ventilation on left-to-right shunt and regional cerebral oxygen saturation: a self-controlled trial"],"prefix":"10.1186","volume":"19","author":[{"given":"Peiyi","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4734-5949","authenticated-orcid":false,"given":"Wei","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,9]]},"reference":[{"key":"852_CR1","doi-asserted-by":"publisher","unstructured":"Brienza N, Biancofiore G, Cavaliere F, Corcione A, De Gasperi A, De Rosa RC, et al. 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