Kopman E A, Ferguson T B
J Thorac Cardiovasc Surg. 1985 May;89(5):706-8.
In 50 patients who underwent coronary bypass grafting, the interaction of left- and right-sided filling pressures were prospectively evaluated to determine whether restoration and/or maintainance of a normal central venous pressure/pulmonary capillary wedge pressure (CVP/PCWP) ratio could improve biventricular performance. In 40 patients, the CVP/PCWP ratio was normal (less than 1) and termination of cardiopulmonary bypass was uneventful. In 10 patients, during loading at the termination of extracorporeal circulation, CVP exceeded PCWP and the ratio was reversed (less than 1). Cardiac index and systolic arterial pressure were low. Restoration of normal ratio by emptying the right heart helped in the improvement of systolic arterial pressure and cardiac index. Thus, in the presence of reversed CVP/PCWP ratio at the termination of cardiopulmonary bypass, restoration of the ratio may prevent unnecessary pharmacologic and/or mechanical intervention, such as inotropic agents, balloon pumps, or assist devices.
在50例行冠状动脉搭桥术的患者中，前瞻性评估左右心室充盈压的相互作用，以确定恢复和/或维持正常的中心静脉压/肺毛细血管楔压（CVP/PCWP）比值是否能改善双心室功能。40例患者的CVP/PCWP比值正常（小于1），体外循环终止顺利。10例患者在体外循环结束时负荷过程中，CVP超过PCWP，比值逆转（大于1）。心脏指数和收缩期动脉压较低。通过排空右心恢复正常比值有助于改善收缩期动脉压和心脏指数。因此，在体外循环结束时CVP/PCWP比值逆转的情况下，恢复该比值可避免不必要的药物和/或机械干预，如使用正性肌力药物、球囊泵或辅助装置。
