EVALUATION OF THE TOTAL SHUNT AND THE
ALVEOLO-ARTERIAL OXYGEN TENSION DIFFERENCE IN ACUTE RESPIRATORY FAILURE IN
CHILDREN
Nguyen Dinh Hai
Pediatric Intensive Care Unit, Nhan Dan Gia Dinh Hospital, Vietnam
Objectives: A prospective study was carried out to:
-Evaluate the change of the total shunt in the acute the change of the
total shunt in the acute respiratory failure. –Follow up the response in
the treatment of acute respiratory failure.
Patients and methods: 3 groups of patients
from 1 to 15 years of age (cardiac patients are excluded) –Group 1:
included 50 patients with acute respiratory failure due to pulmonary
diseases. –Group 2: included 50 healthy children. –Group 3: included 20
patients with acute respiratory failure due to extra pulmonary diseases.
All patients with acute respiratory failure received oxygen and an adequate
management (Antibiotics for pneumonia, bronchodilators and corticosteroids
for asthma and bronchiolitics).
Results: 1). All of 50 patients with pulmonary deseases
(group 1) –Have an elevated total shout of 8-15%, increased AaDPO2
of 11-20 mmHg, decreased PaO2 of 90-80mmHg in slightly
respiratory failure. –Moderately elevated shunt of 16-35% highly elevated
AaDPO2 of 20-40 mmHg and very decreased PaO2 of under 60mmHg in
the Severe respiratory failure. 2). All healthy patients of group 2 have
normal shunt, normal AaDPO2 and PaO2 of normal limit. 3) All patients with
extra pulmonary diseases (group 3) have normal shunt, normal AaDPO2
and decreased PaO2-all of serviced patients of group 1 and 3 have normal shunt, normal
AaDPO2 and PaO2 of normal limit after treatment.
Conclusion: The total shunt is an important under of
arterial blood gas in the association with evaluate quantitatively and
locate the locality of disorders in the oxygenation in acute respiratory
failure: -The elevation of the total shunt and AaDPO2, decreased
PaO2 in acute respiratory failure indicateds the disorder of the
oxygenation is original from pulmonary disease. –The normal shunt and
normal AaDPO2 associated with decreases PaO2 indicate
that the disorder is original from extra pulmonary diseases. –All survived
patients achieved a therapeutic response with total shunt and AaDPO2
of normal values after treatment.