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急性出血时肺动脉压和混合静脉血氧张力与其他指标的比较:一项实验研究

Comparison of pulmonary artery pressures and mixed venous oxygen tension with other indices in acute haemorrhage: an experimental study.

作者信息

Pardy B J, Dudley H A

出版信息

Br J Surg. 1977 Jan;64(1):1-5. doi: 10.1002/bjs.1800640102.

Abstract

A pulmonary artery cannula allows the determination of free and wedge pulmonary artery pressures and mixed venous oxygen tension. These indices have been reported to provide useful information in the assessment of the haemodynamic status of the ill patient. The purpose of this study was to compare them with systemic arterial and central venous pressures as predictors of cardiac output during acute continuous haemorrhage in the dog. Pulmonary artery pressure changed almost linearly with cardiac ouput, and the percentage changes in each were similar; by contrast, systemic arterial pressure was an inferior predictor of cardiac output. Pulmonary artery wedge pressure fell rapidly in the initial phase of bleeding, but right atrial pressure more gradually. The oxygen tension of blood in the pulmonary artery fell steadily during haemorrhage. These findings suggest that data derived from the use of a pulmonary artery cannula may be more useful than systemic arterial and central venous pressures in the detection of hypovolaemia and reduced cardiac output; more frequent use of a pulmonary artery cannula should be made in patients in whom blood volume may fluctuate rapidly.

摘要

肺动脉插管可用于测定肺动脉自由压、楔压以及混合静脉血氧分压。据报道,这些指标在评估患病患者的血流动力学状态时能提供有用信息。本研究的目的是将它们与体动脉压和中心静脉压进行比较,以作为犬急性持续性出血期间心输出量的预测指标。肺动脉压随心输出量几乎呈线性变化,且二者的百分比变化相似;相比之下,体动脉压作为心输出量的预测指标较差。在出血初始阶段,肺动脉楔压迅速下降,而右心房压下降较为缓慢。出血期间,肺动脉内血液的氧分压稳步下降。这些发现表明,在检测低血容量和心输出量降低方面,使用肺动脉插管获得的数据可能比体动脉压和中心静脉压更有用;对于血容量可能快速波动的患者,应更频繁地使用肺动脉插管。

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