Wakerlin G E, Finn J C, Siegel L C, Benson G V, Flavin T F, Pearl R G
Department of Anesthesia, Stanford University School of Medicine, CA 94305, USA.
Anesth Analg. 1995 Jul;81(1):17-23. doi: 10.1097/00000539-199507000-00004.
Pulmonary capillary pressure (Ppc), the major factor responsible for pulmonary edema, cannot be directly measured in intact subjects but may be estimated by analysis of the pressure decay profile after pulmonary artery catheter balloon inflation. We compared three different methods of pulmonary artery occlusion pressure (Ppao) decay profile analysis to estimates of Ppc derived from lymph flow measurements in halothane-anesthesized sheep. The relationship between Ppc and lymph flow was first determined by increasing Ppc by left atrial balloon inflation, and was then used to determine Ppc during pulmonary hypertension produced by infusion of a thromboxane analog. All three methods of Ppao decay profile analysis demonstrated a correlation with Ppc estimated from lymph flow. However, the method using a single exponential analysis significantly overestimated Ppc, and none of the methods reliably estimated changes in the longitudinal distribution of pulmonary vascular resistance during pulmonary hypertension. These results suggest that Ppao decay profile analysis as currently performed has limited application.
肺毛细血管压（Ppc）是导致肺水肿的主要因素，在完整的受试者中无法直接测量，但可通过分析肺动脉导管球囊充气后的压力衰减曲线来估算。我们比较了三种不同的肺动脉闭塞压（Ppao）衰减曲线分析方法，以评估在氟烷麻醉的绵羊中通过淋巴流量测量得出的Ppc估计值。首先通过左心房球囊充气增加Ppc来确定Ppc与淋巴流量之间的关系，然后用于确定在输注血栓素类似物导致肺动脉高压期间的Ppc。所有三种Ppao衰减曲线分析方法均显示与根据淋巴流量估算的Ppc相关。然而，使用单指数分析的方法显著高估了Ppc，并且在肺动脉高压期间，没有一种方法能够可靠地估算肺血管阻力纵向分布的变化。这些结果表明，目前进行的Ppao衰减曲线分析应用有限。
