Assessment of the sensitivity of hydrogen inhalation in the detection of left-to-right shunting

E. D. Flores, R. A. Lange, J. B. Bedotto, R. S. Danziger, L. D. Hillis

Research output: Contribution to journalArticle

Abstract

For the detection of left-to-right intracardiac shunting, the oximetric and standard indocyanine green techniques are relatively insensitive, in that neither can reliably detect a shunt with a ratio of pulmonary to systemic flow (Qp/Qs) <1.3 (percentage shunt, 23%). Although the hydrogen inhalation method is said to be much more sensitive in this regard, no previous study has measured its sensitivity. Accordingly, in 15 patients (4 men, 11 women, aged 38 to 67 years) without intracardiac shunting, hydrogen inhalation was performed 1) without and 2) with an artificially created femoral arteriovenous shunt of known size, and cardiac output was measured by thermodilution. For the 15 subjects with cardiac outputs of 3.64 to 8.10 liters/min, shunts of 22 to 248 ml/min were created, so that the shunts ranged from 0.5% to 3.3%. Hydrogen inhalation detected all shunts ≥ 1.3% (Qp/Qs ≥ 1.01). Of the 10 shunts <1.3%, it detected 5, with the smallest being 0.7%. Thus, the hydrogen inhalation technique is extremely sensitive in identifying the presence of left-to-right shunting, far more sensitive than the oximetric and standard indocyanine green methods.

Original languageEnglish (US)
Pages (from-to)94-98
Number of pages5
JournalCatheterization and Cardiovascular Diagnosis
Volume20
Issue number2
DOIs
StatePublished - 1990
Externally publishedYes

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Inhalation
Hydrogen
Indocyanine Green
Cardiac Output
Thermodilution
Thigh
Lung

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Assessment of the sensitivity of hydrogen inhalation in the detection of left-to-right shunting. / Flores, E. D.; Lange, R. A.; Bedotto, J. B.; Danziger, R. S.; Hillis, L. D.

In: Catheterization and Cardiovascular Diagnosis, Vol. 20, No. 2, 1990, p. 94-98.

Research output: Contribution to journalArticle

Flores, E. D. ; Lange, R. A. ; Bedotto, J. B. ; Danziger, R. S. ; Hillis, L. D. / Assessment of the sensitivity of hydrogen inhalation in the detection of left-to-right shunting. In: Catheterization and Cardiovascular Diagnosis. 1990 ; Vol. 20, No. 2. pp. 94-98.
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