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导管尺寸对犬肺小肺静脉内记录压力的影响。

Effect of catheter size on pressures recorded in small pulmonary veins in dog lung.

作者信息

Nicolaysen G, Shepard J, Tanita T, Onizuka M, Hall C, Staub N C

机构信息

Department of Physiology, University of Oslo, Norway.

出版信息

J Appl Physiol (1985). 1991 Oct;71(4):1296-301. doi: 10.1152/jappl.1991.71.4.1296.

Abstract

Controversy continues about the contribution of the veins to pulmonary vascular resistance. From data obtained in studies using intravascular catheters, it appears that a major fraction (up to 44%) of the total pulmonary vascular pressure drop resides in larger (greater than 1.0 mm diam) veins, whereas micropuncture data and various models give much less pressure drop. Theoretically, artifactual pressure drops can be obtained if an intravascular catheter partly obstructs the vessel. We made measurements of pressure in the same lung vein with two different-sized catheters (1.2 and 0.6 mm OD, respectively). In paired experiments the larger catheter always measured a higher pressure than the smaller one, except close to the large lobar vein outlet. In some of the experiments we measured the diameter of the vessel containing the indwelling catheter by freezing the lung and then serial-sectioned the frozen lung. From these data we could infer that the range of vein diameter in the which the smaller catheter measured a lower pressure was 1.5-4 mm. We conclude that the larger catheter overestimated the pressure because of greater obstruction. The pressures obtained with the smaller catheter suggest that little (less than 10%) of the total pulmonary vascular resistance resides in veins larger than approximately 1 mm diam under zone 3 baseline conditions.

摘要

关于静脉对肺血管阻力的贡献,争议仍在继续。从使用血管内导管的研究中获得的数据来看,似乎肺血管总压力降的很大一部分(高达44%)存在于较大(直径大于1.0毫米)的静脉中,而微穿刺数据和各种模型给出的压力降要小得多。理论上,如果血管内导管部分阻塞血管,可能会获得人为的压力降。我们用两种不同尺寸的导管(外径分别为1.2毫米和0.6毫米)对同一条肺静脉进行了压力测量。在配对实验中,除了靠近大叶静脉出口处,较大的导管测得的压力总是高于较小的导管。在一些实验中,我们通过冷冻肺脏,然后对冷冻的肺脏进行连续切片,测量了留置导管所在血管的直径。从这些数据我们可以推断,较小导管测得压力较低的静脉直径范围是1.5 - 4毫米。我们得出结论,较大的导管由于阻塞较大而高估了压力。在区域3基线条件下,较小导管测得的压力表明,肺血管总阻力中只有很少一部分(小于10%)存在于直径大于约1毫米的静脉中。

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