Agostoni P, Agrifoglio M, Arena V, Doria E, Sala A, Susini G
Istituto di Cardiologia, Università di Milano, Italy.
Chest. 1991 Mar;99(3):642-5. doi: 10.1378/chest.99.3.642.
We measured systemic to pulmonary bronchial blood flow [Qbr(s-p)] during total cardiopulmonary bypass in 15 patients with mitral stenosis and elevated pulmonary venous pressure (group A, mean pulmonary wedge pressure = 22.2 +/- 5.4 mm Hg, mean +/- SD) and in 15 patients with coronary artery diseases and normal pulmonary venous pressure (group B). Qbr(s-p) is the volume of blood accumulating in the left side of the heart in the absence of pulmonary and coronary flows. This blood was vented through a cannula introduced into the left atrium and measured. Qbr(s-p) was 76.3 +/- 13.9 ml/min (2.18 +/- 0.37 percent of extracorporeal circulation pump flow) and 22.3 +/- 2.1 (0.63 +/- 0.15) in group A and B, respectively (p less than 0.01). During total cardiopulmonary bypass, pulmonary venous pressure is approximately atmospheric pressure, and no differences in systemic blood pressure, extracorporeal circulation pump flow, and airways pressure were observed between group A and B. Therefore, vascular resistance through the bronchial vessels draining into the pulmonary circulation is reduced in patients with mitral stenosis and elevated pulmonary venous pressure.
我们在15例二尖瓣狭窄且肺静脉压升高的患者（A组，平均肺楔压 = 22.2±5.4 mmHg，均值±标准差）以及15例冠状动脉疾病且肺静脉压正常的患者（B组）进行全心肺转流期间测量了体循环至肺循环的支气管血流量[Qbr(s-p)]。Qbr(s-p)是在无肺循环和冠状动脉血流时积聚在心脏左侧的血液量。这些血液通过插入左心房的套管引出并进行测量。A组和B组的Qbr(s-p)分别为76.3±13.9 ml/min（体外循环泵流量的2.18±0.37%）和22.3±2.1（0.63±0.15）（p<0.01）。在全心肺转流期间，肺静脉压约为大气压，A组和B组之间在体循环血压、体外循环泵流量和气道压力方面未观察到差异。因此，二尖瓣狭窄且肺静脉压升高的患者经支气管血管流入肺循环的血管阻力降低。
