Abstract
Introduction. Diagnosis and timely correction of low cardiac output syndrome in newborns after cardiaс
surgery is one of the most complex tasks of intensive therapy of critical conditions in children.
Objectives: to study the dynamics of arterial and central venous blood gas analysis in newborns with low cardiac
output syndrome after cardiaс surgery and determine their prognostic significance.
Materials and methods. Fifty newborns with congenital heart disease after surgery were examined in the in
the period from 2014 to 2018. Blood gas analysis was carried out at two stages: stage I – low cardiac output
syndrome in the early postoperative period; stage II – period of stabilization.
Results. It has been established that threshold values for verification of low cardiac output are reduction of
partial oxygen tension in venous blood up to 30 mm Hg, the saturation of the central venous blood with oxygen
up to 56%, an increase in the arteriovenous difference in oxygen up to 39%, and an increase in the oxygen
extraction ratio of up to 41%. Increase in arterio-venous difference in partial pressure of carbon dioxide
to 11 mm Hg is a sign of progressive heart failure, and probability of death increases fourfold.
Conclusion. The arteriovenous difference in carbon dioxide is a reliable diagnostic criterion of low cardiac
output syndrome in neonates with biventricular physiology. Increase of arteriovenous difference in carbon
dioxide to 11 mm Hg indicates a high risk of an unfavorable outcome.
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About the authors
- Khubulava Gennadiy Grigor'evich, Dr. Med. Sc., Academician of Russain Academy of Sciences, Head of the Department, Cardiac Surgeon; orcid.org/0000-0001-8873-7071
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Naumov Aleksey Borisovich, Cand. Med. Sc., Assistant Professor, Anesthesiologist; orcid.org/0000-0003-0323-0162
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Marchenko Sergey Pavlovich, Dr. Med. Sc., Professor, Cardiac Surgeon; orcid.org/0000-0003-4785-4532
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Chupaeva Olga Yur'evna, Anesthesiologist; orcid.org/0000-0003-4204-6915
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Seliverstova Anastasiya Alekseevna, Pediatric Cardiologist; orcid.org/0000-0003-2992-2255
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Aleksandrovich Yuriy Stanislavovich, Dr. Med. Sc., Professor, Head of the Department; orcid.org/0000-0002-2131-4813
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Pshenisnov Konstantin Viktorovich, Cand. Med. Sc., Assistant Professor, Anesthesiologist; orcid.org/0000-0003-1113-5296
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Pilyugov Nikolai Gennadievich, Chief of Department; orcid.org/0000-0002- 5905-683X
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Tereshenko Ol'ga Yur'evna, Anesthesiologist; orcid.org/0000-0003-4629-1061
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Popova Liliya Leont'evna, Pediatric Cardiologist; orcid.org/0000-0003- 0622-8367
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Andreev Mikhail Sergeevich, Resident of the Department of Cardiac Surgery; orcid.org/0000-0002-4700-0265
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Mal'tseva Ol'ga Sergeevna, Anesthesiologist; orcid.org/0000-0001-8653-0915
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Nevmerzhitskaya Oksana Vladimirovna, Cand. Med. Sc., Deputy Chief Physician of Neonatology; orcid.org/0000-0002-3993-6899
