Sofer S, Baer R, Gussarsky Y, Lieberman A, Bar-Ziv J
Intensive Care Med. 1984;10(6):317-9. doi: 10.1007/BF00254324.
A 22-month-old girl with the syndrome of hypoventilation, pulmonary hypertension, cor pulmonale and pulmonary edema due to adenoidal hypertrophy is described. Adenoidectomy resulted in relief of all symptoms and signs within 24 h. Hemodynamic study using pulmonary artery catheter showed that the pulmonary artery pressure returned to normal 48 h after relief of the obstruction. The normal left ventricular end-diastolic pressure, measured throughout the period of obstruction, in the presence of severe pulmonary edema, could suggest a non-cardiogenic "low pressure" pulmonary edema. However, the highly negative pleural pressure which existed during upper airway obstruction indicated an elevation of transmural left ventricular end diastolic pressure (compared to pulmonary wedge pressure) and thus, suggested that the pulmonary edema in this syndrome is secondary to both - right and left heart failure.
本文描述了一名22个月大的女孩，因腺样体肥大导致通气不足、肺动脉高压、肺心病和肺水肿综合征。腺样体切除术后24小时内所有症状和体征均得到缓解。使用肺动脉导管进行的血流动力学研究表明，梗阻解除后48小时肺动脉压力恢复正常。在严重肺水肿的情况下，整个梗阻期间测量的正常左心室舒张末期压力可能提示非心源性“低压”肺水肿。然而，上呼吸道梗阻期间存在的高度负压表明跨壁左心室舒张末期压力升高（与肺楔压相比），因此提示该综合征中的肺水肿继发于右心和左心衰竭。
