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[LAP和心输出量对肺气体交换的影响。心脏外科手术患者的术中研究(作者译)]

[The influence of LAP and cardiac output on the pulmonary gas exchange. Intraoperative studies in cardio-surgical patients (author's transl)].

作者信息

Voigt E, van Deyk K, Seybold-Epting W

出版信息

Anaesthesist. 1981 May;30(5):237-42.

PMID:6787948
Abstract

In 21 patients haemodynamic parameters and pulmonary gas exchange were investigated after open heart surgery with cardio-pulmonary bypass (aortic valve replacement, AVR (n = 8); mitral valve replacement, MVR (n = 6); aorto coronary bypass; ACB (n = 7). For describing gas exchange function of the lung the O2-CO2 diagram was used. Stepwise increase of left atrial pressure (LAP) was followed by increasing cardiac output (CO) only in the AVR and ACB groups, whereas in the MVR group CO did not increase. Rising venous admixture (Qs/Qt) under these circumstances was related to CO only in the AVR and ACB groups. In the MVR group Qs/Qt did not change. Qs/Qt is related to low VA/Q areas in the lung. Increased CO leads to rising Qs/Qt from these low VA/Q-areas.

摘要

对21例接受体外循环心脏直视手术的患者(主动脉瓣置换术,AVR(n = 8);二尖瓣置换术,MVR(n = 6);主动脉冠状动脉搭桥术,ACB(n = 7))的血流动力学参数和肺气体交换进行了研究。使用O2-CO2图来描述肺的气体交换功能。仅在AVR组和ACB组中,随着左心房压力(LAP)的逐步升高,心输出量(CO)增加,而在MVR组中CO并未增加。在这些情况下,静脉混合血(Qs/Qt)升高仅在AVR组和ACB组中与CO相关。在MVR组中,Qs/Qt没有变化。Qs/Qt与肺内低通气/血流比值区域有关。CO增加会导致这些低通气/血流比值区域的Qs/Qt升高。

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