Ohtaka M, Erdmann A J, Lappas D G
J Thorac Cardiovasc Surg. 1980 May;79(5):741-7.
The relationship between the plasma colloid osmotic pressure/pulmonary capillary wedge pressure difference (PCOP-PCWP) and the development of gas exchange abnormalities was examined prior to, during, and after cardiac operations in 13 patients with pulmonary hypertension owing to mitral and/or aortic valvular disease. Alveolar-arterial oxygen tension gradient [P(A-a)DO2] and pulmonary shunt fraction (Qs/Qt) were used as indices of gas exchange impairment owing to accumulated lung water. During the baseline period, PCOP-PCWP was -8.5 +/- 2.6 mm Hg; P(A-a)DO2, 352.5 +/- 30.1 mm Hg; and Qs/Qt, 17.0% +/- 1.5%. There were no significant correlations between PCOP-PCWP and P(A-a)DO2 or Qs/Qt at any time during the study. Thus PCOP-PCWP does not predict susceptibility to lung water accumulation reliably in patients with pulmonary hypertension, and other protective factors may contribute to unimpaired gas exchange, even in the setting of profound hemodilution and low PCOP.
在13例因二尖瓣和/或主动脉瓣疾病导致肺动脉高压的患者心脏手术前、手术期间和手术后，研究了血浆胶体渗透压/肺毛细血管楔压差值（PCOP - PCWP）与气体交换异常发展之间的关系。肺泡 - 动脉氧分压差[P(A - a)DO2]和肺分流分数（Qs/Qt）被用作因肺水积聚导致气体交换受损的指标。在基线期，PCOP - PCWP为 - 8.5±2.6 mmHg；P(A - a)DO2为352.5±30.1 mmHg；Qs/Qt为17.0%±1.5%。在研究期间的任何时间，PCOP - PCWP与P(A - a)DO2或Qs/Qt之间均无显著相关性。因此，PCOP - PCWP不能可靠地预测肺动脉高压患者肺水积聚的易感性，即使在严重血液稀释和低PCOP的情况下，其他保护因素也可能有助于维持气体交换正常。
