Acute Hemodynamic Effects of Red Cell Volume Reduction in Polycythemia of Cyanotic Congenital Heart Disease
Amnon Rosenthal,David G. Nathan,Alan T. Marty,Lawrence N. Button,Olli S. Miettinen,Alexander S. Nadas +5 more
TLDR
The replacement of whole blood with plasma or 5% albumin is shown to result in an increased systemic blood flow and oxygen delivery and Hypervolemia in hypoxic polycythemia should be maintained in order to sustain an adequate SBF.Abstract:
Acute reduction in red cell volume (RCV) without significant alterations of blood volume in 22 patients with severe polycythemia secondary to cyanotic congenital heart disease resulted in a decrease in peripheral vascular resistance and an increase in stroke volume, systemic blood flow (SBF), and systemic oxygen transport. These changes are probably related to the decreased blood viscosity and yield shear stress associated with lower red cell concentrations. Hypervolemia in hypoxic polycythemia should be maintained in order to sustain an adequate SBF. In contrast to acute phlebotomy which may be expected to decrease blood oxygen content and SBF, the replacement of whole blood with plasma or 5% albumin is shown to result in an increased systemic blood flow and oxygen delivery.read more
Citations
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Journal ArticleDOI
Blood is thicker than water: the management of hyperviscosity in adults with cyanotic heart disease.
TL;DR: Until newer approaches to decreasing hematocrit without inducing iron deficiency are shown to be safe and efficacious, phlebotomy should be used for the acute resolution of hyperviscosity symptoms, and the use of hydroxyurea should be limited to patients with recurrent symptoms.
Journal ArticleDOI
The Adult Patient With Eisenmenger Syndrome: A Medical Update After Dana Point Part III: Specific Management and Surgical Aspects
Erwin Oechslin,Siegrun Mebus,Ingram Schulze-Neick,Koichiro Niwa,Pedro T. Trindade,Andreas Eicken,Alfred Hager,Irene Lang,John R. Hess,Harald Kaemmerer +9 more
TL;DR: This medical update emphasizes the current diagnostic and therapeutic options for Eisenmenger patients with particularly focussing on specific management and surgical aspects of physicians specialized on congenital heart diseases and PAH.
Journal ArticleDOI
Systemic oxygen transport in patients with congenital heart disease.
TL;DR: O2 saturation cannot be predicted or calculated accurately from measured Po2, but must be measured directly, 2,3-DPG, hemoglobin concentration, and P50 fluctuate to stabilize arterial oxygen content, SOT is determined primarily by cardiac output in subjects who are adapted chronically.
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Influence of Acute Variations in Hematocrit on the QRS Complex of the Frank Electrocardiogram
TL;DR: It is postulated that the effect of high intracavitary blood hematocrit in polycythemia in reducing early QRS voltages is due to its influence on radial myocardial excitation propagated from endocardium to epicardium.
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Myocardial blood flow and its distribution in anesthetized polycythemic dogs.
TL;DR: It is concluded that autoregulation plays a role in regulating flows and oxygen transport in polycythemia, and with maximal coronary vasodilation, the increased viscosity of polycythemic blood could be an important factor reducing the amount of myocardial blood flow and oxygen Transport.
References
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