Cardiopulmonology Department, Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil,
Cancer Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil,
Respiration. 2019;98(3):253-262. doi: 10.1159/000501342. Epub 2019 Aug 7.
Acute pulmonary embolism (PE) impairs hemodynamics, gas exchange, and lung mechanical capacity. Considering PE pathophysiology, most attention has been paid to hemodynamic impairment. However, the most prevalent symptoms in PE patients come from gas exchange alterations, which have not been in the spotlight for many years. Pulmonary physiology and consequent gas exchange impairment play a pivotal role in the high risk of death from PE. In this review, we will look at the pathophysiology of PE, from the vascular occlusion to the resultant heterogeneity in pulmonary perfusion and gas exchange impairment, discussing in detail its causes and consequences.
急性肺栓塞(PE)会损害血液动力学、气体交换和肺机械能力。考虑到 PE 的病理生理学,大多数注意力都集中在血液动力学损害上。然而,PE 患者最常见的症状来自气体交换的改变,这些改变多年来一直没有受到关注。肺生理学和随之而来的气体交换受损在 PE 死亡风险高的情况下起着关键作用。在这篇综述中,我们将探讨 PE 的病理生理学,从血管阻塞到肺灌注和气体交换受损的异质性,详细讨论其原因和后果。