Kumon K, Tanaka K, Nakajima N, Naito Y, Fujita T
Jpn Circ J. 1985 Oct;49(10):1055-62. doi: 10.1253/jcj.49.1055.
The pulmonary circulation of 41 patients with low cardiac output syndrome (LOS) in the recovery period following open heart surgery was studied. Cardiac indices (CI) of these patients in LOS was 1.64 +/- 0.28 (Mean +/- SD) L/min X m2 and increased to 2.60 +/- 0.50 L/min X m2 after the stabilization of hemodynamic conditions. Mean pulmonary arterial pressure, pulmonary arteriolar resistance index (PARI) and total pulmonary resistance index (TPRI) in the condition of LOS were very high and significantly decreased after recovery from LOS, although the mean left atrial pressure showed no significant change. The correlation coefficient (r) between CI and PARI was found to be -0.574. High Pao2 with reductions of alveolar-arterial oxygen tension difference (A-aDo2) and physiological pulmonary shunt ratio (Qs/Qt) in LOS significantly decreased concomitant with significant increases in both A-aDo2 and Qs/Qt after the stabilization of the hemodynamic condition. Moderate correlations were obtained between CI and Pao2 (r = -0.478), and high correlations were established between CI and physiological pulmonary shunt flow (Qps) (r = 0.747). These studies showed that pulmonary vasoconstriction was playing a major role in the elevation of pulmonary vascular resistance in LOS, which eventually leads to the reduction of intrapulmonary shunting.
对41例心脏直视手术后处于恢复期的低心排血量综合征（LOS）患者的肺循环进行了研究。这些患者在LOS时的心脏指数（CI）为1.64±0.28（均值±标准差）L/（min·m²），在血流动力学状况稳定后增至2.60±0.50L/（min·m²）。LOS状态下的平均肺动脉压、肺小动脉阻力指数（PARI）和总肺阻力指数（TPRI）非常高，从LOS恢复后显著降低，尽管平均左心房压无显著变化。发现CI与PARI之间的相关系数（r）为-0.574。LOS时高Pao₂伴肺泡-动脉氧分压差（A-aDo₂）和生理性肺分流率（Qs/Qt）降低，在血流动力学状况稳定后，A-aDo₂和Qs/Qt均显著增加，同时Pao₂显著降低。CI与Pao₂之间呈中度相关（r = -0.478），CI与生理性肺分流血量（Qps）之间呈高度相关（r = 0.747）。这些研究表明，肺血管收缩在LOS时肺血管阻力升高中起主要作用，最终导致肺内分流减少。
