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Ann Thorac Surg 1992;54:150-151
© 1992 The Society of Thoracic Surgeons

Articles

Carbon dioxide prevents pulmonary overcirculation in hypoplastic left heart syndrome

David R. Jobes, MD*, Susan C. Nicolson, MD, James M. Steven, MD, Margaret Miller, MD, Marshall L. Jacobs, MD, William I. Norwood, MD, PhD

The Children's Hospital of Philadelphia and The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania USA

Accepted for publication October 15, 1991.

* Address reprint requests to Dr Jobes, Department of Anesthesia, The Hospital of The University of Pennsylvania, 4 North Dulles Bldg, 3400 Spruce St, Philadelphia, PA 19104.

Circulatory and metabolic homeostasis in patients with hypoplastic left heart syndrome is dependent on a delicate balance between systemic and pulmonary blood flow. Hypocarbia can result in a marked decrease in pulmonary vascular resistance accompanied by pulmonary overcirculation, systemic hypotension, metabolic acidosis, and death. This report illustrates that early and precise control of the arterial carbon dioxide tension using inspired carbon dioxide can be effective in preventing or treating instability arising during management of a patient with hypoplastic left heart syndrome.




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