Sakamoto T, Yamada T
J Thorac Cardiovasc Surg. 1977 Apr;73(4):578-82.
Immediately after mitral commissurotomy, we measured pulmonary blood volume by dye-dilution method and investigated the relationships between pulmonary blood volume and other hemodynamic parameters. Pulmonary blood volume correlated directly to pulmonary mean transit time, cardiac index, stroke volume index, and mean left atrial pressure. Pulmonary blood volume increased with mean pulmonary arterial pressures up to 35 mm. Hg but decreased with elevation above this level. The same patterns were observed in the correlations between pulmonary blood volume and both pulmonary distending pressure and pulmonary vascular resistance. These observations suggest that the changes of the pulmonary vessels begin with the elevation of mean pulmonary arterial pressure above 35 mm. Hg, pulmonary distending pressure above 25 mm. Hg or pulmonary vascular resistance above 5 units. Therefore, it is desirable to maintain mean pulmonary arterial pressure below 35 mm. Hg in patients immediately after mitral commissurotomy.
二尖瓣交界切开术后，我们立即采用染料稀释法测量肺血容量，并研究肺血容量与其他血流动力学参数之间的关系。肺血容量与肺平均通过时间、心脏指数、每搏量指数及平均左房压呈正相关。肺血容量随平均肺动脉压升高至35mmHg而增加，但高于此水平时则降低。肺血容量与肺扩张压及肺血管阻力之间的相关性也观察到相同模式。这些观察结果表明，肺血管的变化始于平均肺动脉压高于35mmHg、肺扩张压高于25mmHg或肺血管阻力高于5单位。因此，对于二尖瓣交界切开术后的患者，将平均肺动脉压维持在35mmHg以下是可取的。
