{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:35:00Z","timestamp":1786739700634,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,7]]},"abstract":"\n Background :<\/jats:title>\n Pulmonary vascular resistance, an important determinant of shunting across ventricular septal defects (VSD), rises at both extremes of lung volume.<\/jats:p>\n <\/jats:sec>\n \n Aims :<\/jats:title>\n We sought to determine the effect of changes in tidal volumes (VT) on pulmonary blood flow (Qp), systemic blood flow (Qs), and shunt (Qp\/Qs) in children with VSD.<\/jats:p>\n <\/jats:sec>\n \n Setting :<\/jats:title>\n Single-center teaching hospital.<\/jats:p>\n <\/jats:sec>\n \n Design :<\/jats:title>\n Prospective observational study.<\/jats:p>\n <\/jats:sec>\n \n Methods :<\/jats:title>\n Thirty children with a mean age of 11.8 \u00b1 5 months undergoing surgical closure of VSD were studied. Hemodynamics and shunt-related parameters were assessed using transthoracic echocardiography measured at three different VT i.e. 10, 8, and 6-ml\/kg keeping the minute ventilation constant.<\/jats:p>\n <\/jats:sec>\n \n Results :<\/jats:title>\n \n Reduction in VT from 10 to 8 to 6 ml\/kg led to a reduction in gradient across VSD measuring 23.5, 20 and 13 mmHg respectively (\n P<\/jats:italic>\n < 0.001). Similarly, right ventricluar outflow tract (RVOT) diameter, RVOT velocity time integral, Qp (57.3 \u00b1 18.1, 50.6 \u00b1 16.9, 39.9 \u00b1 14.7 mL;\n P<\/jats:italic>\n < 0.001), Qs (24.1 \u00b1 10.4, 20.0 \u00b1 8.7, 15.3 \u00b1 6.9 mL;\n P<\/jats:italic>\n < 0.001) and peak airway pressure (17.2 \u00b1 1.5, 15.8 \u00b1 1.3, 14.5 \u00b1 1.2 cmHg;\n P<\/jats:italic>\n < 0.001) showed progressive decline with decreasing VT from 10 to 8 to 6 ml\/kg, respectively. However, Qp\/Qs (2.4 \u00b1 0.4, 2.6 \u00b1 0.4, 2.6 \u00b1 0.4) demonstrated a minor increasing trend.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion :<\/jats:title>\n \n Lower V\n T<\/jats:sub>\n reduces the gradient across VSD, the pulmonary blood flow, and the peak airway pressure. Hence, ventilation with lower V\n T<\/jats:sub>\n and higher respiratory rate maintaining adequate minute ventilation might be preferable in children with VSD. Further studies are required to confirm the findings of this pilot study.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/apc.apc_1_21","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T07:23:38Z","timestamp":1629444218000},"page":"350-355","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Effect of change in tidal volume on left to right shunt across ventricular septal defect in children \u2013 A pilot study"],"prefix":"10.4103","volume":"14","author":[{"given":"Pravin","family":"Pathak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sambhunath","family":"Das","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh Kumar","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suruchi","family":"Hasija","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arindam","family":"Choudhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parag","family":"Gharde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeti","family":"Makhija","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Chauhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R3-14-20240901","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/BF00795710","article-title":"Symptomatic heart disease in infants: Comparison of three studies performed during 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