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Updated: Jun 2, 2026

Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism
Published on: February 14, 2022
Negative pressure ventilation as a therapy for post-operative complications in a patient with single ventricle
Shriprasad R Deshpande1, Paul M Kirshbom, Kevin O Maher
1Pediatric Cardiology Division, Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA 30322, United States. deshpandes@kidsheart.com
Objective:
To report the use of negative pressure ventilation as a therapeutic rescue in a patient with post-operative complications of Kawashima procedure.
Design:
Case report.
Setting:
Paediatric cardiac critical care unit in a tertiary care teaching hospital.
Patient:
Nine month-old patient with single ventricle physiology developed complications after Kawashima procedure that were worsened by use of positive pressure ventilation.
Intervention:
Utilisation of negative pressure ventilation due to its unique cardiopulmonary interactions and haemodynamic effects.
Measurements And Main Results:
There was gradual and persistent improvement in the passive diastolic pulmonary blood flow through the Kawashima circuit along with improvement in oxygenation and ventilation. The patient was successfully weaned off ventilator support and discharged to home.
Conclusion:
Patients with single ventricle physiology depend on passive diastolic blood flow to the lungs through surgical pathways such as Fontan or Kawashima circuits. Prolonged use of positive pressure ventilation can significantly affect this forward flow and result in haemodynamic compromise. Use of negative pressure ventilation with its unique cardiopulmonary interactions can be an effective rescue as demonstrated in our case.
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