Hemodynamic Impact of Mechanical Ventilation in Anesthetized Patients With Cavopulmonary Connection: A…

StudyJournal of cardiothoracic and vascular anesthesia· Nov 2025

Hemodynamic Impact of Mechanical Ventilation in Anesthetized Patients With Cavopulmonary Connection: A Physiologic Crossover Study.

Yevgeni Plotkin, Margaret J Klein, Neil Patel … Sheldon Stohl

Cardiac & Thoracic AnesthesiaStudyTreatmentQ2IF 1.6

Spontaneous breathing gives higher cardiac index than mechanical ventilation in Fontan/Glenn patients

Hemodynamic Impact of Mechanical Ventilation in Anesthetized Patients With Cavopulmonary Connection: A Physiologic Crossover Study.

Yevgeni Plotkin … Sheldon Stohl

Journal of cardiothoracic and vascular anesthesia · Nov 2025 · Q2 in Anesthesiology

Purpose

In patients with single-ventricle hearts and cavopulmonary connection, both pulmonary and systemic blood flow rely on passive venous drainage through the lungs.

Methods

The cardiac catheterization laboratory, Children's Hospital Los Angeles, Los Angeles, California.

Results

0.6

L/min/m²

spontaneous breathing raises cardiac output over mechanical ventilation

More results

Atrial pressure was also higher with spontaneous breathing (mean difference: 1.9 mmHg, p < 0.001).

Pulmonary vascular resistance, transpulmonary gradient, and the ratio of pulmonary to systemic blood flow (Qp: Qs) did not differ significantly between ventilation methods.

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Conclusion · 1 of 2

In anesthetized Glenn and Fontan patients with secured airways, spontaneous ventilation produces a superior hemodynamic profile compared with mechanical ventilation.

Conclusion · 2 of 2

The current data suggest that the enhanced cardiac output results from increased systemic ventricular preload. These results should guide perioperative ventilatory management and interpretation of catheterization data in this population.

Hemodynamic Impact of Mechanical Ventilation in Anesthetized Patients With Cavopulmonary Connection: A Physiologic Crossover Study.

Hemodynamic Impact of Mechanical Ventilation in Anesthetized Patients With Cavopulmonary Connection: A Physiologic Crossover Study.

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