The public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
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Digital Trial Lecture – time and place
Adjudication committee
- First opponent: Professor Vibeke Elisabeth Hjortdal, Copenhagen University Hospital, Rigshospitalet, Denmark
- Second opponent: Deputy Head of Division, Dr. med., Harald Noddeland, Oslo University Hospital
- Third member and chair of the evaluation committee: Professor Kristin Bjørnland, University of Oslo
Chair of the Defence
Professor II Guttorm Haugen, Faculty of Medicine, University of Oslo
Principal Supervisor
Senior Consultant, Professor Gunnar Norgård, Oslo University Hospital and University of Bergen
Summary
The Fontan procedure has revolutionized the treatment of univentricular hearts. However, it is associated with severe complications related to the hemodynamic compromise in the Fontan circulation and altered transcapillary fluid balance. Low cardiac output and fluid accumulation with edema formation, impaired respiratory function and prolonged pleural effusion are of concern. Fluid accumulation with edema formation is common after surgery for congenital heart defects in children. The mechanism is only partly known.
The transcapillary fluid exchange is dependent on the difference in intravascular and interstitial colloid osmotic pressure. Interstitial colloid osmotic pressure has not previously been studied in the pediatric population.
The aim of the thesis was to evaluate intravascular and interstitial colloid osmotic pressure in children with congenital heart defect. Interstitial fluid was collected using the wick method.
In the first paper the normal values in plasma and interstitial colloid osmotic pressures for children at different age group were established.
The next studies in children, with a simple or a complex heart defect revealed that they had lower colloid osmotic pressures than healthy children.
In the second paper the changes in colloid osmotic pressure were evaluated in a simple cardiac defect during two different procedures, with and without the use of cardiopulmonary bypass. The contribution of cardiopulmonary bypass on changes in colloid osmotic pressures could then be evaluated. The use of cardiopulmonary bypass led to more pronounced changes that was associated with fluid accumulation.
In the third paper these mechanisms were evaluated in children undergoing the Fontan procedure. Transcapillary fluid filtration led to fluid accumulation in these patients. Reduced interstitial colloid osmotic pressure was associated with pleural effusion. Fluid accumulation after Fontan surgery can be predicted by changes in colloid osmotic pressures.
Additional information
Contact the research support staff.