Abstract
Previous studies demonstrating maldistribution of pulmonary blood flow in patients who had undergone Fontan procedures (FP) predict high physiologic dead space during exercise. We used non-invasive exercise testing to assess gas exchange in 5 patients age 10-19, compared to 11 age and sex matched controls. Oxygen saturation was measured by ear oximetry at rest and after exercise. The ventilatory equivalents for oxygen (Ve/VO2) and carbon dioxide (Ve/VCO2) were measured during progressive exercise and mixed expired pCO2 (PeCO2) and end-tidal pCO2 (PetCO2) were measured during steady state exercise on a cycle ergometer. We obtained the following results: In addition, the patients had a mean oxygen saturation of 89±6% at rest and desaturated further during exercise (81±11, p<0.05). These data show high ventilation for O2 consumption and CO2 production, low expired CO2 concentrations and oxygen desaturation during exercise. The results strongly indicate elevated physiologic dead space and ventilation perfusion mismatch consistent with maldistribution of pulmonary blood flow.
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