Various mixtures of inhaled gases have been used clinically to affect pulmonary vasomotor tone for infants with certain congenital heart defects such as hypoplastic left-heart syndrome (HLHS). Our ability to manipulate the concentrations of oxygen and carbon dioxide may be the chief determinant of survival. I report a case of an infant with HLHS who, following the Stage-1 Norwood Procedure, required treatment with FDO2 < 0.21 and hypercarbia (15 torr) to maintain a normal ratio of pulmonary-to-systemic vascular resistance.
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