Slutsky R A, Peck W W, Mancini G B, Shabetai R
Am Heart J. 1984 Jul;108(1):90-6. doi: 10.1016/0002-8703(84)90549-0.
Pulmonary congestion is usually absent in cardiac tamponade. To examine the effects of experimental pericardial tamponade on pulmonary fluid volumes, we studied 14 anesthetized dogs with indicator-dilution techniques to measure extravascular (EVLW) and intravascular (PBV) pulmonary fluid volumes. Seven dogs were studied at two levels of tamponade and seven were studied during two levels of left atrial (LA) hypertension produced with an LA balloon. EVLW and PBV were measured in both groups at control state and then at two levels of elevated LA pressure (P). When LAP was raised by the balloon, PBV rose with the increase in LAP (4.9 +/- 2 cc/kg control at LAP 1.2 +/- 1.0 mm Hg versus 6.8 +/- 2.1 cc/kg at LAP 8.4 +/- 1.4 mm Hg and 6.8 +/- 2.1 cc/kg at LAP 14.7 +/- 2.0 mm Hg; both intervention PBV values p less than 0.01 vs control). During tamponade, PBV did not change (4.1 +/- 1.1 cc/kg at LAP 1.3 +/- 2.2 mm Hg control versus 4.4 +/- 1.0 cc/kg at LAP 7.4 +/- 1.4 mm Hg and 4.8 +/- 1.3 cc/kg at LAP 12.7 +/- 2.8 mm Hg). EVLW changes were similar during elevation of LAP in both groups (tamponade dogs 7.1 +/- 2.6 cc/kg, 7.1 +/- 1.6 cc/kg and 8.9 +/- 2.1 cc/kg, respectively; and LA hypertension dogs 6.9 +/- 2.5 cc/kg, 7.3 +/- 2.0 cc/kg, and 8.0 +/- 2.0 cc/kg, respectively. We conclude that during cardiac tamponade there is little change in PBV in response to rises in LAP. This is significantly different from the changes seen when increasing LAP by inflating an LA balloon, where fluid is shifted from the peripheral to the central circulation. EVLW changes were similar for the two methods during elevation of LAP.
心脏压塞时通常不存在肺充血。为了研究实验性心包压塞对肺液体容量的影响，我们用指示剂稀释技术研究了14只麻醉犬，以测量血管外（EVLW）和血管内（PBV）肺液体容量。7只犬在两种心包压塞水平下进行研究，7只犬在通过左心房（LA）球囊产生的两种左心房（LA）高血压水平下进行研究。在对照组状态下以及在两种升高的LA压力（P）水平下，对两组犬的EVLW和PBV进行测量。当通过球囊使LAP升高时，PBV随着LAP的升高而增加（LAP为1.2±1.0 mmHg时对照组PBV为4.9±2 cc/kg，而LAP为8.4±1.4 mmHg时PBV为6.8±2.1 cc/kg，LAP为14.7±2.0 mmHg时PBV为6.8±2.1 cc/kg；两种干预下的PBV值与对照组相比p均小于0.01）。在心包压塞期间，PBV没有变化（LAP为1.3±2.2 mmHg对照组时PBV为4.1±1.1 cc/kg，而LAP为7.4±1.4 mmHg时PBV为4.4±1.0 cc/kg，LAP为12.7±2.8 mmHg时PBV为4.8±1.3 cc/kg）。两组在LAP升高期间EVLW的变化相似（心包压塞组犬分别为7.1±2.6 cc/kg、7.1±1.6 cc/kg和8.9±2.1 cc/kg；LA高血压组犬分别为6.9±2.5 cc/kg、7.3±2.0 cc/kg和8.0±2.0 cc/kg）。我们得出结论，在心包压塞期间，PBV对LAP升高的反应变化很小。这与通过向LA球囊充气增加LAP时所观察到的变化显著不同，此时液体从外周循环转移到中心循环。在LAP升高期间，两种方法的EVLW变化相似。
