Uehara H, Takenaka I, Aoyama K, Kadoya T, Sata T, Shigematsu A
Department of Anaesthesiology, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-ku Kitakyushu 807-8555, Japan.
Anaesthesia. 2000 Feb;55(2):113-7. doi: 10.1046/j.1365-2044.2000.055002113.x.
The response of arterial blood pressure to an increase in intrathoracic pressure has been shown to be predictive of pulmonary capillary wedge pressure. We devised a new method, which we termed the arterial pressure ratio. We defined arterial pressure ratio as the ratio of systolic blood pressure of the final beat during the strain phase of the Valsalva manoeuvre to that during apnoea before the manoeuvre, and tested the accuracy of arterial pressure ratio in predicting pulmonary capillary wedge pressure. In 30 patients scheduled for elective abdominal aortic reconstruction, following induction of general anaesthesia and tracheal intubation, a 20-G catheter and pulmonary artery catheter were inserted through the radial artery and right internal jugular vein, respectively. Pulmonary capillary wedge pressure was then measured during a brief period of apnoea and the Valsalva manoeuvre was performed by application of pressure to the reservoir bag. Airway pressure was maintained at 30 cmH2O for 10 s and then released. Radial arterial pressure and airway pressure were recorded simultaneously, and arterial pressure ratio was calculated. There was a close linear correlation between arterial pressure ratio and pulmonary capillary wedge pressure (r = 0.88, p < 0.0001).
动脉血压对胸内压升高的反应已被证明可预测肺毛细血管楔压。我们设计了一种新方法，称之为动脉压比值。我们将动脉压比值定义为瓦尔萨尔瓦动作用力阶段最后一次搏动的收缩压与动作前呼吸暂停期间收缩压的比值，并测试了动脉压比值预测肺毛细血管楔压的准确性。在30例计划进行择期腹主动脉重建的患者中，全身麻醉诱导和气管插管后，分别通过桡动脉和右颈内静脉插入一根20G导管和肺动脉导管。然后在短暂呼吸暂停期间测量肺毛细血管楔压，并通过对贮气囊施加压力来进行瓦尔萨尔瓦动作。气道压力维持在30 cmH₂O 10秒，然后释放。同时记录桡动脉压和气道压力，并计算动脉压比值。动脉压比值与肺毛细血管楔压之间存在密切的线性相关性（r = 0.88，p < 0.0001）。
