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高龄对冠状动脉搭桥手术期间血管外肺水积聚的影响。

Effects of advanced age on extravascular lung water accumulation during coronary artery bypass surgery.

作者信息

Gallagher J D, Moore R A, Kerns D, Jose A B, Botros S B, Clark D L

出版信息

Crit Care Med. 1985 Feb;13(2):68-71. doi: 10.1097/00003246-198502000-00002.

Abstract

Pulmonary extravascular thermal volume (ETVL) accumulation during aortocoronary bypass grafting (CABG) was compared between nine patients (group 1) aged 49 +/- 2 (SEM) yr and nine patients (group 2) aged 65 +/- 1.2 yr, using the thermal-dye technique. Before extracorporeal bypass (ECB), ETVL was significantly correlated with age and mean ETVL was significantly lower in group 1 (3.93 +/- 0.48 ml/kg body weight) than group 2 (5.93 +/- 0.38 ml/kg). During ECB, ETVL rose to 5.15 +/- 0.65 ml/kg in group 1 (p less than .05) and to 6.38 +/- 0.56 ml/kg in group 2. By the next morning, ETVL had returned to pre-ECB levels. Post-ECB, cardiac index decreased in group 1 and colloid osmotic pressure decreased in both groups, but all values returned to pre-ECB levels by the next morning. Although PaO2 had decreased and pulmonary shunt fraction had increased by this time, changes in these variables did not correlate with changes in ETVL. During ECB, ETVL increased transiently but returned to pre-ECB levels by the next morning.

摘要

采用热染料技术,比较了9例年龄为49±2(标准误)岁的患者(第1组)和9例年龄为65±1.2岁的患者(第2组)在冠状动脉搭桥术(CABG)期间肺血管外热容积(ETVL)的蓄积情况。在体外循环(ECB)前,ETVL与年龄显著相关,第1组的平均ETVL(3.93±0.48 ml/kg体重)显著低于第2组(5.93±0.38 ml/kg)。在ECB期间,第1组的ETVL升至5.15±0.65 ml/kg(p<0.05),第2组升至6.38±0.56 ml/kg。到第二天早上,ETVL已恢复到ECB前的水平。ECB后,第1组的心指数下降,两组的胶体渗透压均下降,但所有值到第二天早上均恢复到ECB前的水平。尽管此时PaO2下降且肺分流分数增加,但这些变量的变化与ETVL的变化无关。在ECB期间,ETVL短暂增加,但到第二天早上又恢复到ECB前的水平。

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