Tanabe K, Asanuma T, Yoshitomi H, Kobayashi K, Nakamura K, Okada S, Shimizu H, Sano K, Shimada T
The Fourth Department of Internal Medicine, Shimane Medical University, Izumo, Japan.
Am J Cardiol. 1996 Nov 15;78(10):1145-8. doi: 10.1016/s0002-9149(96)90068-5.
Pulmonary artery (PA) end-diastolic pressure is used as an estimate of PA wedge pressure. We evaluated contrast enhanced pulmonary regurgitant signals in the assessment of PA end-diastolic pressure in 24 patients in a critical care unit. Right atrial pressure was estimated by the percent decrease of the inferior vena caval diameter with inspiration. Weak or absent pulmonary regurgitant signals were enhanced by sonicated albumin (Albunex) in 23 patients (96%). The Doppler-determined PA end-diastolic pressure (the sum of the pulmonary regurgitant pressure gradient at end-diastole and the right atrial pressure) was significantly correlated with the catheter-determined PA end-diastolic pressure (y = 0.85x + 1.72, r = 0.93). Compared with invasive hemodynamic monitoring, the contrast-enhanced Doppler technique using Albunex is effective for measuring PA end-diastolic pressure, even in critically ill patients.
肺动脉（PA）舒张末期压力被用作肺动脉楔压的估计值。我们评估了24例重症监护病房患者中对比增强的肺动脉反流信号在评估PA舒张末期压力中的作用。通过吸气时下腔静脉直径的减小百分比来估计右心房压力。23例患者（96%）中，弱或无的肺动脉反流信号通过超声白蛋白（Albunex）得到增强。多普勒测定的PA舒张末期压力（舒张末期肺动脉反流压力梯度与右心房压力之和）与导管测定的PA舒张末期压力显著相关（y = 0.85x + 1.72，r = 0.93）。与有创血流动力学监测相比，使用Albunex的对比增强多普勒技术即使在重症患者中也能有效测量PA舒张末期压力。
