Lotto A, Salvadè P, Gattinoni L, Rota M, Bianchi G P
G Ital Cardiol. 1976;6(7):1184-93.
Hemodynamic and hemogasanalytic comparative study was performed in 46 patients admitted to our Coronary Care Unit because of myocardial infarction. The values of pH; PO2; PCO2; HbaO2; HbvO2; SBP; CVP; PAP; WP; Q; and CI were recorded simultaneously in every patient one or more times during the first 72 hours of the disease. The patients were divided into four classes according to the severity of hemodynamic impairment. Statistical analysis of the obtained results was then performed. In all patients more or less severe hypoxemia was found, but it was not statistically related to the severity of hemodynamic impairment. Instead, the values of PvO2 and HbvO2 showed a very significant correlation with Q and CI. Moreover, in 11 patients the venous admixture (QVA/Q) was measured several times in order to study the cause of the arterial hypoxemia thoroughly. It showed a very significant direct correlation with Q and CI. The interpretation of this phenomenon is then discussed and it is suggested that, in such patients, an increase of cardiac output causes an increased flow through poorly ventilated areas.
对因心肌梗死入住我院冠心病监护病房的46例患者进行了血流动力学和血液气体分析的对比研究。在疾病的最初72小时内,对每位患者进行了一次或多次同时记录pH、PO₂、PCO₂、HbaO₂、HbvO₂、SBP、CVP、PAP、WP、Q和CI的值。根据血流动力学损害的严重程度将患者分为四类。然后对所得结果进行统计分析。在所有患者中均或多或少发现了严重的低氧血症,但在统计学上它与血流动力学损害的严重程度无关。相反,PvO₂和HbvO₂的值与Q和CI显示出非常显著的相关性。此外,为了深入研究动脉低氧血症的原因,对11例患者多次测量了静脉混合血(QVA/Q)。它与Q和CI显示出非常显著的直接相关性。然后对这一现象进行了解释,并提出在这类患者中,心输出量的增加导致流经通气不良区域的血流增加。