Best Poster Award at 2023 CCAS Meeting Goes to UPMC Children’s Congenital Cardiac Anesthesiology and Cardiac Catheterization Teams for Fontan Ventilation Trial

UPMC Children's Hospital of Pittsburgh Congenital Cardiac Anesthesiology and Cardiac Catheterization teams were recently honored with the "Best Poster" award at the 2023 Congenital Cardiac Anesthesia Society (CCAS) Meeting. Their abstract was distinguished as one of only five to be presented orally.

The team’s clinical trial, titled "Impact of Fontan Ventilation Strategy on Cardiac Output: An Invasive Physiologic Crossover Study" (ClinicalTrials.gov Identifier: NCT04672538), is spearheaded by Phillip Adams, DO, FASA (principal investigator), the UPMC Congenital Cardiac Anesthesiology team (Aparna S. Phadke, MD; Lindsay Stollings, MD; Brian Blasiole, MD, PhD; Khoa N. Nguyen, MD; Patrick M. Callahan, MD), and the UPMC Children's Heart Institute Cardiac Catheterization Team (Brian Goldstein, MD; Sarah Trucco, MD; Alexandra Erdman, MD; Jacqueline Kreutzer, MD).

The primary objective of the study is to investigate the ramifications of positive pressure ventilation strategies on patients exhibiting Fontan physiology. This physiology emerges as the final stage of single-ventricle palliation, resulting in passive pulmonary blood flow with each vena cava anastomosed directly to the pulmonary arteries. Patients with Fontan physiology who presented for elective outpatient cardiac catheterizations were randomized to initiate their cardiac catheterization with either a high or low tidal volume setting. Subsequent to measuring pressures and blood oxygen levels, patients transitioned to the alternate ventilation strategy and measurements were repeated. The study team maintained consistent minute-ventilation, examining the potential impact of higher tidal volumes with slower respiratory rates as opposed to lower tidal volumes with higher respiratory rates on cardiac output.

In a preliminary assessment of the data, the emerging trend suggests that eschewing higher tidal volumes during positive pressure ventilation may yield a more favorable cardiac output. Since the submission of this abstract, the research team has successfully completed patient recruitment and is currently preparing their final analysis.

The study team expresses their gratitude to the UPMC Heart and Vascular Institute for its support of the trial, and they eagerly anticipate the publication of complete results of this pivotal clinical trial.