Vol. 23 No. 3 (2019)
ANESTHESIOLOGY & RESUSCITATION

Theoretical models of changes in haemodynamic parameters and gas exchange in univentricular circulation

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  • G. Khubulava,
  • A. Naumov,
  • S. Marchenko,
  • O. Chupaeva,
  • A. Seliverstova,
  • N. Pilyugov,
  • O. Tereshenko,
  • Yu. Aleksandrovich,
  • K. Pshenisnov,
  • L. Popova,
  • M. Andreev,
  • O. Nevmerzhitskaya,
  • A. Volkov
G. Khubulava
Pavlov First Saint Petersburg State Medical University, Saint Petersburg
A. Naumov
Saint Petersburg State Pediatric Medical University, Saint Petersburg
S. Marchenko
Saint Petersburg State Pediatric Medical University, Saint Petersburg
O. Chupaeva
Saint Petersburg State Pediatric Medical University, Saint Petersburg
A. Seliverstova
Saint Petersburg State Pediatric Medical University, Saint Petersburg
N. Pilyugov
Saint Petersburg State Pediatric Medical University, Saint Petersburg
O. Tereshenko
Saint Petersburg State Pediatric Medical University, Saint Petersburg
Yu. Aleksandrovich
Saint Petersburg State Pediatric Medical University, Saint Petersburg
K. Pshenisnov
Saint Petersburg State Pediatric Medical University, Saint Petersburg
L. Popova
Saint Petersburg State Pediatric Medical University, Saint Petersburg
M. Andreev
Saint Petersburg State Pediatric Medical University, Saint Petersburg
Bio
O. Nevmerzhitskaya
Saint Petersburg Maternity Hospital No 18, Saint Petersburg
A. Volkov
S.M. Kirov Saint Petersburg Military Medical Academy, Saint Petersburg
DOI: https://doi.org/10.21688/1681-3472-2019-3-65-75

Published 2019-11-27

Keywords

  • blood gas analysis,
  • functionally single ventricle,
  • hemodynamic

How to Cite

Khubulava, G., Naumov, A., Marchenko, S., Chupaeva, O., Seliverstova, A., Pilyugov, N., Tereshenko, O., Aleksandrovich, Y., Pshenisnov, K., Popova, L., Andreev, M., Nevmerzhitskaya, O., & Volkov, A. (2019). Theoretical models of changes in haemodynamic parameters and gas exchange in univentricular circulation. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 23(3), 65–75. https://doi.org/10.21688/1681-3472-2019-3-65-75

Copyright (c) 2019 Khubulava G. G., Naumov A. B., Marchenko S. P., Chupaeva O. Yu., Seliverstova A. A., Pilyugov N. G., Tereshenko O. Yu., Aleksandrovich Yu. S., Pshenisnov K. V., Popova L. L., Andreev M. S., Nevmerzhitskaya O. V., Volkov A. M.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Aim. To develop theoretical models of changes in haemodynamic parameters of patients with univentricular haemodynamics.
Methods. We analysed the effects of redistributing blood flow between the two circulatory systems (pulmonary and systemic) on systemic oxygen delivery and examined changes in the arterial and venous blood gas compositions. Mathematical analyses on the basis of oxygen flow into the pulmonary circulatory system and its consumption during circulation were performed according to Fick principle for cardiac output. Calculations were performed using equations describing changes in the delivery and consumption of oxygen during univentricular circulation. Furthermore, computer simulations were employed to investigate changes in haemodynamic parameters and gas exchange associated with pathological processes such as pulmonary venous hypoxemia, reduction in systemic flow rate and mixed venous blood desaturation. Calculations were performed under conditions with oxygen concentration of >0% or <100%.
Results. A number of theoretical models were developed, which described (i) the distribution of systemic and pulmonary blood flow and changes in arterial oxygenation depending on Qp/Qs; (ii) the ratio of systemic blood flow to Qp/Qs; (iii) changes in arterial oxygenation depending on Qp/Qs at different levels of central venous saturation; (iv) changes in pulmonary venous saturation depending on arterial saturation and Qp/Qs under conditions of normal and reduced blood flow; (v) level of central venous saturation depending on changes in Qp/Qs and SpvO2 at systemic SaO2 of 75% and (vi) PaO2 dynamics depending on changes in PpvO2 and Qp/Qs.
Conclusion. Changes in the oxygen status of patients with univentricular haemodynamics with sufficient combined cardiac output are indicative of the distribution of blood flow. Assessments of the developed models demonstrated that a number of additional factors affect changes in the oxygen composition of blood including (i) the initial level of arterial oxygenation; (ii) the level of oxygenation in the pulmonary veins and (iii) the ratio of pulmonary to systemic blood flow. In addition, the results indicated that PCO2 recorded in the pulmonary veins, arteries and mixed venous blood largely depends on Qp/Qs. The theoretical models presented here can be used to compare the results of haemodynamic status assessments of patients with univentricular physiology.
 
Received 22 May 2019. Revised 4 November 2019. Accepted 10 November 2019.
 
Funding: The study did not have sponsorship.
 
Conflict of interest: Authors declare no conflict of interest.
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