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2 results

  • Larger lung volumes in fetuses with transposition of the great arteries and an intact ventricular septum compared to heart healthy fetuses and fetuses with transposition of the great arteries and a ventricular septal defect

  • Emil Krogh, Signe Gade Hellmuth, Ditte Staub Jørgensen, Benjamin Kelly, Niels Vejlstrup, Olav Petersen, Vibeke E. Hjortdal, Mette H. Lauridsen
  • Journal:
    Cardiology in the Young , First View
    Published online by Cambridge University Press:
    07 May 2026, pp. 1-6
    • Article
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  • Background:

    Complex CHDs may impair organ development. One proposed mechanism is an altered relationship between blood flow, oxygen delivery, and subsequent organ growth. In this study, we examined whether fetal lung, intracranial, liver, and kidney volumes differ among fetuses with transposition of the great arteries with an intact ventricular septum, transposition of the great arteries with a ventricular septal defect, and healthy controls.

    Methods:

    Eleven fetuses with transposition of the great arteries (6 with a ventricular septal defect and 5 with an intact ventricular septum) and 22 healthy controls were scanned between 1 and 3 times at gestational age 27–38 weeks, using fetal MRI. We measured lung, total intracranial, liver, and kidney volumes and compared fetuses with and without transposition of the great arteries while subsequently correcting for ventricular septal defect/intact ventricular septum status, estimated fetal weight, and gestational age, using mixed effects regression analysis.

    Results:

    Fetuses with transposition of the great arteries+intact ventricular septum had significantly larger lung volumes compared to controls. After adjusting for estimated fetal weight and gestational age, median lung volume ratio (transposition of the great arteries+intact ventricular septum vs. controls) was 1.30 (95% CI: 1.08–1.57; p = 0.005). No difference was found in lung volume between fetuses with transposition of the great arteries+ventricular septal defect and controls. No significant differences in total intracranial, liver, and kidney volumes were found between transposition of the great arteries+ventricular septal defect, transposition of the great arteries+intact ventricular septum, and controls.

    Conclusion:

    In this preliminary study, late-gestation fetuses with transposition of the great arteries-intact ventricular septum had a 30% larger lung volume compared with both transposition of the great arteries-ventricular septal defect and healthy controls. Together with existing evidence of higher fetal pulmonary blood flow and increased oxygen saturation in transposition of the great arteries-intact ventricular septum, these findings support a potential link between blood flow, oxygen delivery, and organ growth.

  • 12 - Conscious sedation

  • from 1 - Ventilation
  • Edited by J. S. Gravenstein, University of Florida, Michael B. Jaffe, Nikolaus Gravenstein, University of Florida, David A. Paulus, University of Florida
  • Book:
    Capnography
    Published online:
    05 August 2011
    Print publication:
    17 March 2011, pp 102-114

  • Summary

    Since gas exchange is a primordial function of the lungs and the conductive airways, respiratory assessment is of paramount importance. Capnography has been utilized in surgical patients for over three decades to confirm tracheal intubation and assess ventilation. Nitrogen washout provides an estimate of functional residual capacity, total lung volume, deadspace volume, and alveolar volume. Clinicians typically utilize exhaled CO2 concentration against time during a respiratory cycle. A number of applications are available in and out of the operating room. Capnography can be used as a continuous monitor of alveolar ventilation in patients with lung disease or hemodynamic instability. Mainstream capnometry appears to provide more accurate PETCO2 than conventional sidestream capnometry during spontaneous breathing in non-intubated patients. In the opinion of some investigators, the technology should be employed in all cases requiring sedation in or out of the operating room.