PULMONARY-HYPERTENSION IN SEVERE ACUTE RESPIRATORY-FAILURE
PULMONARY-HYPERTENSION IN SEVERE ACUTE RESPIRATORY-FAILURE
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DOI：
10.1056/nejm197703032960903
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发表时间：
1977-01-01
影响因子：
158.5
通讯作者：
SNIDER, MT
中科院分区：
文献类型：
--
作者：
ZAPOL, WM;SNIDER, MT
对30例因各种原因引起的严重急性呼吸衰竭接受治疗的患者进行了反复的肺和全身血流动力学评估。纠正全身性低氧血症后，所有患者均出现肺动脉高压和肺血管阻力升高。通过输注异丙肾上腺素增加肺血流量或通过心脏右侧部分旁路减少肺血流量，对肺动脉压的影响最小。虽然肺血管阻力升高或低心脏指数都不能可靠地预测死亡，但幸存者的肺血管阻力随着时间的推移而逐渐下降，但死亡患者倾向于维持或增加肺血管阻力。所有患者的右室每搏做功指数均明显升高。肺血管阻力升高对右心室施加的工作负荷可能是限制严重急性呼吸衰竭患者存活的一个因素。
Pulmonary and systemic hemodynamics were repeatedly assessed in 30 patients undergoing therapy for severe acute respiratory failure of diverse causes. Pulmonary-artery hypertension and elevated pulmonary vascular resistance were observed in all patients after correction of systemic hypoxemia. Increasing pulmonary blood flow by isoproterenol infusion or decreasing pulmonary blood flow by partial bypass of the right side of the heart minimally altered pulmonary-artery pressure. Although neither elevated pulmonary vascular resistance or low cardiac index reliably predicted death, survivors had progressive decreases of pulmonary vascular resistance with time, but nonsurvivors tended to maintain or increase pulmonary vascular resistance. Right ventricular stroke-work index was markedly elevated in all patients. The work load imposed upon the right ventricle by elevation of pulmonary vascular resistance may be a factor limiting survival in severe acute respiratory failure.