Savino J A, Jabbour I, Agarwal N, Byme D
Department of Surgery, New York Medical College, Valhalla 10595.
Am J Surg. 1988 Apr;155(4):572-7. doi: 10.1016/s0002-9610(88)80412-4.
The hemodynamic effects of pneumatic antishock garment application in high-risk elderly patients were examined in 10 preoperative patients (mean age 66.5 +/- 6.4 years) with the pneumatic antishock garments uninflated, after 15 minutes of inflation to 50 mm Hg, and after 15 minutes of inflation to 75 mm Hg. After inflation, significant increases in right atrial pressure (89 percent), pulmonary capillary wedge pressure (34 percent), and mean pulmonary artery pressure (21 percent) were noted. Mean peripheral arterial pressure increased 11.2 percent. Depression of the cardiac index (18 percent), left ventricular stroke work (20 percent), and right ventricular stroke work (16.4 percent) with associated increases in total peripheral resistance (26 percent) and pulmonary vascular resistance (18 percent) occurred in 5 of 10 patients. Left ventricular function curves revealed a progressive decrease in ventricular function at 50 mm Hg and 75 mm Hg. We have concluded that the effect of the pneumatic antishock garment on myocardial function is variable and unpredictably dangerous in the elderly patient with diminished myocardial reserve. As no significant benefit was derived from inflation pressures greater than 50 mm Hg in these patients, the lowest combination of pressures producing the most efficacious results should be used.
对10例术前患者（平均年龄66.5±6.4岁）在未充气、充气至50mmHg 15分钟后以及充气至75mmHg 15分钟后，研究了气动抗休克衣应用于高危老年患者的血流动力学效应。充气后，右心房压力显著升高（89%）、肺毛细血管楔压显著升高（34%）、平均肺动脉压显著升高（21%）。平均外周动脉压升高11.2%。10例患者中有5例出现心脏指数降低（18%）、左心室每搏功降低（20%）、右心室每搏功降低（16.4%），同时总外周阻力增加（26%）、肺血管阻力增加（18%）。左心室功能曲线显示在50mmHg和75mmHg时心室功能逐渐下降。我们得出结论，对于心肌储备功能减退的老年患者，气动抗休克衣对心肌功能的影响是可变的且具有不可预测的危险性。由于这些患者充气压力大于50mmHg时未获得显著益处，应使用产生最有效结果的最低压力组合。
