Noninvasive detection and quantification of left-to-right shunts in children using oxygen-15 labeled carbon dioxide

D. M. Tamer, D. D. Watson, P. J. Kenny, W. R. Janowitz, H. Gelband, A. J. Gilson

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

A method for the detection and quantification of left-to-right intracardiac shunts is described which utilizes a single breath inhalation of oxygen-15 labeled carbon dioxide (C 15O 2). The inhaled gas rapidly crosses the alveolar membrane and the oxygen-15 label is exchanged through the carbonate cycle to form oxygen-15 labeled water within the pulmonary capillary blood. Pulmonary indicator clearance curves are measured by external scintillation probes. A simplified method of shunt flow quantification was developed from indicator dilution principles and used for the analysis of the clearance curves. Inhalation studies were performed with 62 children on the day prior to cardiac catheterization. The presence or absence of left-to-right shunt was confirmed by contrast angiography in all cases. Twenty-six children were found to have no shunts by C 15O 2 inhalation, oximetry or angiography. Of the 36 with shunts, 34 were detected by C 15O 2. Two of these were designated as equivocal because they were considered to be less than the threshold of definitive detection by C 15O 2 (having Qp/Qs less than 1.2); 32 were positive and three were two false negatives with small ventricular septal defects. There were no false positives by C 15O 2. The correlation coefficient between C 15O 2 and oximetry values of shunt flow for those patients with proven shunts was 0.82.

Original languageEnglish
Pages (from-to)626-631
Number of pages6
JournalCirculation
Volume56
Issue number4
StatePublished - Dec 1 1977
Externally publishedYes

Fingerprint

Carbon Dioxide
Inhalation
Oximetry
Oxygen
Angiography
Lung
Ventricular Heart Septal Defects
Carbonates
Cardiac Catheterization
Gases
Membranes
Water

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Tamer, D. M., Watson, D. D., Kenny, P. J., Janowitz, W. R., Gelband, H., & Gilson, A. J. (1977). Noninvasive detection and quantification of left-to-right shunts in children using oxygen-15 labeled carbon dioxide. Circulation, 56(4), 626-631.

Noninvasive detection and quantification of left-to-right shunts in children using oxygen-15 labeled carbon dioxide. / Tamer, D. M.; Watson, D. D.; Kenny, P. J.; Janowitz, W. R.; Gelband, H.; Gilson, A. J.

In: Circulation, Vol. 56, No. 4, 01.12.1977, p. 626-631.

Research output: Contribution to journalArticle

Tamer, DM, Watson, DD, Kenny, PJ, Janowitz, WR, Gelband, H & Gilson, AJ 1977, 'Noninvasive detection and quantification of left-to-right shunts in children using oxygen-15 labeled carbon dioxide', Circulation, vol. 56, no. 4, pp. 626-631.
Tamer DM, Watson DD, Kenny PJ, Janowitz WR, Gelband H, Gilson AJ. Noninvasive detection and quantification of left-to-right shunts in children using oxygen-15 labeled carbon dioxide. Circulation. 1977 Dec 1;56(4):626-631.
Tamer, D. M. ; Watson, D. D. ; Kenny, P. J. ; Janowitz, W. R. ; Gelband, H. ; Gilson, A. J. / Noninvasive detection and quantification of left-to-right shunts in children using oxygen-15 labeled carbon dioxide. In: Circulation. 1977 ; Vol. 56, No. 4. pp. 626-631.
@article{20bc91d951c148adb02e4b66b1562f1d,
title = "Noninvasive detection and quantification of left-to-right shunts in children using oxygen-15 labeled carbon dioxide",
abstract = "A method for the detection and quantification of left-to-right intracardiac shunts is described which utilizes a single breath inhalation of oxygen-15 labeled carbon dioxide (C 15O 2). The inhaled gas rapidly crosses the alveolar membrane and the oxygen-15 label is exchanged through the carbonate cycle to form oxygen-15 labeled water within the pulmonary capillary blood. Pulmonary indicator clearance curves are measured by external scintillation probes. A simplified method of shunt flow quantification was developed from indicator dilution principles and used for the analysis of the clearance curves. Inhalation studies were performed with 62 children on the day prior to cardiac catheterization. The presence or absence of left-to-right shunt was confirmed by contrast angiography in all cases. Twenty-six children were found to have no shunts by C 15O 2 inhalation, oximetry or angiography. Of the 36 with shunts, 34 were detected by C 15O 2. Two of these were designated as equivocal because they were considered to be less than the threshold of definitive detection by C 15O 2 (having Qp/Qs less than 1.2); 32 were positive and three were two false negatives with small ventricular septal defects. There were no false positives by C 15O 2. The correlation coefficient between C 15O 2 and oximetry values of shunt flow for those patients with proven shunts was 0.82.",
author = "Tamer, {D. M.} and Watson, {D. D.} and Kenny, {P. J.} and Janowitz, {W. R.} and H. Gelband and Gilson, {A. J.}",
year = "1977",
month = "12",
day = "1",
language = "English",
volume = "56",
pages = "626--631",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Noninvasive detection and quantification of left-to-right shunts in children using oxygen-15 labeled carbon dioxide

AU - Tamer, D. M.

AU - Watson, D. D.

AU - Kenny, P. J.

AU - Janowitz, W. R.

AU - Gelband, H.

AU - Gilson, A. J.

PY - 1977/12/1

Y1 - 1977/12/1

N2 - A method for the detection and quantification of left-to-right intracardiac shunts is described which utilizes a single breath inhalation of oxygen-15 labeled carbon dioxide (C 15O 2). The inhaled gas rapidly crosses the alveolar membrane and the oxygen-15 label is exchanged through the carbonate cycle to form oxygen-15 labeled water within the pulmonary capillary blood. Pulmonary indicator clearance curves are measured by external scintillation probes. A simplified method of shunt flow quantification was developed from indicator dilution principles and used for the analysis of the clearance curves. Inhalation studies were performed with 62 children on the day prior to cardiac catheterization. The presence or absence of left-to-right shunt was confirmed by contrast angiography in all cases. Twenty-six children were found to have no shunts by C 15O 2 inhalation, oximetry or angiography. Of the 36 with shunts, 34 were detected by C 15O 2. Two of these were designated as equivocal because they were considered to be less than the threshold of definitive detection by C 15O 2 (having Qp/Qs less than 1.2); 32 were positive and three were two false negatives with small ventricular septal defects. There were no false positives by C 15O 2. The correlation coefficient between C 15O 2 and oximetry values of shunt flow for those patients with proven shunts was 0.82.

AB - A method for the detection and quantification of left-to-right intracardiac shunts is described which utilizes a single breath inhalation of oxygen-15 labeled carbon dioxide (C 15O 2). The inhaled gas rapidly crosses the alveolar membrane and the oxygen-15 label is exchanged through the carbonate cycle to form oxygen-15 labeled water within the pulmonary capillary blood. Pulmonary indicator clearance curves are measured by external scintillation probes. A simplified method of shunt flow quantification was developed from indicator dilution principles and used for the analysis of the clearance curves. Inhalation studies were performed with 62 children on the day prior to cardiac catheterization. The presence or absence of left-to-right shunt was confirmed by contrast angiography in all cases. Twenty-six children were found to have no shunts by C 15O 2 inhalation, oximetry or angiography. Of the 36 with shunts, 34 were detected by C 15O 2. Two of these were designated as equivocal because they were considered to be less than the threshold of definitive detection by C 15O 2 (having Qp/Qs less than 1.2); 32 were positive and three were two false negatives with small ventricular septal defects. There were no false positives by C 15O 2. The correlation coefficient between C 15O 2 and oximetry values of shunt flow for those patients with proven shunts was 0.82.

UR - http://www.scopus.com/inward/record.url?scp=0017664067&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0017664067&partnerID=8YFLogxK

M3 - Article

C2 - 332408

AN - SCOPUS:0017664067

VL - 56

SP - 626

EP - 631

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 4

ER -