Síndrome hipoxémico crónico

Despite advances in the surgical and medical management of congenital heart disease during childhood, approximately 5% of adults present with significant arterial oxygen desaturation caused by a right-to-left shunt. Chronic hypoxemia syndrome is a true multisystem disorder that can affect blood viscosity, hematopoietic organs, the coagulation system, respiratory dynamics, exercise physiology, the central nervous system, renal function, uric acid metabolism, endothelial function, the coronary circulation, mechanisms of infection, biliary bilirubin secretion, the locomotor apparatus, and neuroendocrine tumor formation. Affected patients are at a high risk when they go to emergency departments, are hospitalized, need surgery, or become pregnant. Management of these patients necessitates a multidisciplinary approach and treatment should be individualized. The physician should adopt the classic principle of primum non nocere and avoid disturbing a delicate and finely balanced physiological equilibrium.