Williams W H, Olsen G N, Allen W G, Yergin B M
Crit Care Med. 1982 Oct;10(10):636-40. doi: 10.1097/00003246-198210000-00003.
A technique for sampling blood from the damaged pulmonary microvasculature in patients with acute respiratory failure is described. Blood was aspirated through the distal lumen of wedged pulmonary arterial catheters in 28 critically ill patients. Successful aspiration was achieved in 88% of the attempts and 20 ml of blood drawn before sampling was optimal for clearing mixed venous precapillary blood. The blood gas values obtained were classified as "capillary" when the wedge (w) PO2 greater than PaO2 and PwCO2 less than PaCO2 (17 patients, 61%); "mixed venous" when PwO2 and PwCO2 were equal to values obtained from the main pulmonary artery (5 patients, 18%); and "mixed source" when intermediate PwO2 and PwCO2 were noted, i.e., PaO2 greater than PwO2 greater than PVO2 and PwCO2 variably greater than or less than PaCO2 (6 patients, 21%). When mixed venous samples are eliminated, microvascular sampling can be assumed in 82% of the successful aspirations.
本文描述了一种从急性呼吸衰竭患者受损肺微血管中采集血液的技术。对28例危重症患者通过楔入肺动脉导管的远端腔抽取血液。88%的尝试获得了成功，采样前抽取20毫升血液最有利于清除混合静脉前毛细血管血。当楔压（w）PO2大于PaO2且PwCO2小于PaCO2时，所获得的血气值被归类为“毛细血管”（17例患者，61%）；当PwO2和PwCO2等于从主肺动脉获得的值时，归类为“混合静脉”（5例患者，18%）；当观察到中间的PwO2和PwCO2时，即PaO2大于PwO2大于PVO2且PwCO2可变地大于或小于PaCO2时，归类为“混合来源”（6例患者，21%）。当排除混合静脉样本时，82%的成功采样可被认为是微血管采样。
