Vincent R N, Lang P, Chipman C W, Castaneda A R
Am J Cardiol. 1985 Feb 15;55(5):526-9. doi: 10.1016/0002-9149(85)90240-1.
Hemodynamic values measured 12 to 24 hours postoperatively in the intensive care unit (ICU) were compared with those measured at a later cardiac catheterization in 68 patients after closure of ventricular septal defect (VSD). A pulmonary arterial (PA) saturation of more than 80% or a pulmonary to systemic blood flow ratio (Qp:Qs) greater than 1.5 in the ICU were sensitive indicators for identifying patients at risk of having a hemodynamically significant residual left-to-right shunt (Qp:Qs greater than 1.5) at catheterization. Measurement of PA pressure in the ICU was a useful predictor of PA pressure at catheterization. In the absence of factors known to alter PA pressure, measurement of PA pressure in the ICU overestimates what it will be at a subsequent cardiac catheterization. Early assessment of hemodynamics after closure of VSD is useful in identifying patients at risk of having hemodynamically significant residual VSD and those who may have persistent PA hypertension.
对68例室间隔缺损（VSD）修补术后患者，将重症监护病房（ICU）术后12至24小时测得的血流动力学值与稍后的心导管检查时测得的值进行比较。ICU中肺动脉（PA）饱和度超过80%或肺循环与体循环血流量之比（Qp:Qs）大于1.5是识别那些在导管检查时有血流动力学显著意义的残余左向右分流（Qp:Qs大于1.5）风险患者的敏感指标。ICU中PA压力的测量是导管检查时PA压力的有用预测指标。在不存在已知会改变PA压力的因素时，ICU中PA压力的测量会高估其在随后心导管检查时的数值。VSD修补术后血流动力学的早期评估有助于识别有血流动力学显著意义的残余VSD风险的患者以及可能有持续性PA高血压的患者。
