TY - JOUR
T1 - Assessment of the sensitivity of hydrogen inhalation in the detection of left‐to‐right shunting
AU - Flores, Eduardo D.
AU - Lange, Richard A.
AU - Bedotto, John B.
AU - Danziger, Robert S.
AU - Hillis, L. David
PY - 1990/6
Y1 - 1990/6
N2 - For the detection of left‐to‐right intracardiac shunting, the oximetric and standard indocyanine green techniques are relatively insensitive, in that neither can reliably detect a shunt with a ratio of pulmonary to systemic flow (Qp/Qs) < 1.3 (percentage shunt, 23%). Although the hydrogen inhalation method is said to be much more sensitive in this regard, no previous study has measured its sensitivity. Accordingly, in 15 patients (4 men, 11 women, aged 38 to 67 years) without intracardiac shunting, hydrogen inhalation was performed 1) without and 2) with an artificially created femoral arteriovenous shunt of known size, and cardiac output was measured by thermodilution. For the 15 subjects with cardiac outputs of 3.64 to 8.10 liter/min, shunts of 22 to 248 ml/min were created, so that the shunts ranged from 0.5% to 3.3%. Hydrogen inhalation detected all shunts ≥ 1.3% (Qp/Qs ≥ 1.01). Of the 10 shunts < 1.3%, it detected 5, with the smallest being 0.7%. Thus, the hydrogen inhalation technique is extremely sensitive in identifying the presence of left‐to‐right shunting, far more sensitive than the oximetric and standard indocyanine green methods.
AB - For the detection of left‐to‐right intracardiac shunting, the oximetric and standard indocyanine green techniques are relatively insensitive, in that neither can reliably detect a shunt with a ratio of pulmonary to systemic flow (Qp/Qs) < 1.3 (percentage shunt, 23%). Although the hydrogen inhalation method is said to be much more sensitive in this regard, no previous study has measured its sensitivity. Accordingly, in 15 patients (4 men, 11 women, aged 38 to 67 years) without intracardiac shunting, hydrogen inhalation was performed 1) without and 2) with an artificially created femoral arteriovenous shunt of known size, and cardiac output was measured by thermodilution. For the 15 subjects with cardiac outputs of 3.64 to 8.10 liter/min, shunts of 22 to 248 ml/min were created, so that the shunts ranged from 0.5% to 3.3%. Hydrogen inhalation detected all shunts ≥ 1.3% (Qp/Qs ≥ 1.01). Of the 10 shunts < 1.3%, it detected 5, with the smallest being 0.7%. Thus, the hydrogen inhalation technique is extremely sensitive in identifying the presence of left‐to‐right shunting, far more sensitive than the oximetric and standard indocyanine green methods.
KW - hydrogen technique
KW - indocyanine green
KW - intracardiac shunting
KW - oximetry
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U2 - 10.1002/ccd.1810200206
DO - 10.1002/ccd.1810200206
M3 - Article
C2 - 2191785
AN - SCOPUS:0025299659
VL - 20
SP - 94
EP - 98
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
SN - 1522-1946
IS - 2
ER -