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Abstract

Introduction: Venous parameters such as mean circulatory filling pressure, venous resistance, and venous return have largely remained theoretical concepts. In vivo characterization of these has not been frequent. This study utilized high-fidelity hemodynamic data to characterize these parameters and associated effects of vasoactive agents and other physiologic parameters in children with single ventricle parallel circulation after the Norwood operation. Methods: Physiologic data for children after the Norwood operation was collected from the T3 system, which captures data at five-second intervals. Mean circulatory filling pressure, venous resistance, and venous pressure were calculated using previously validated equations and then modeled using vasoactive agents and physiologic parameters to help determine associations between all of these parameters. Machine learning algorithms, specifically Bayesian ridge analysis, were utilized. Results: A total of 27,270 datapoints were analyzed. Average mean circulatory filling pressure was found to be approximately 12.3 mmHg, average venous resistance was found to be approximately 4.8 woods units, and average venous return was found to be 1.9 L/min. Associations with vasoactive agents and other physiologic parameters were identified for each venous parameter. Conclusion: Mean circulatory filling pressure, venous resistance, and venous return can successfully be modeled and have significant associations with vasoactive agents and other physiologic parameters. A more thorough understanding of venous parameters may further highlight what clinical interventions may provide the most utility in maximizing outcomes after the Norwood operation.

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