Rubia M, Gandía F, Duque J L
Servicio de Medicina Intensiva, Hospital Clínico Universitario, Valladolid.
Arch Bronconeumol. 1996 Nov;32(9):483-5. doi: 10.1016/s0300-2896(15)30710-9.
Three cases of postpneumonectomy edema, in which hemodynamic stability was monitored with a Swan-Ganz catheter, are described. Measurement of pressure in the pulmonary capillary was based on the pulmonary artery occlusion curve. High capillary pressure and normal wedge pressure were observed in all 3 cases, suggesting that the rise in net filtration pressure as a consequence of excess flow is the pathogenic mechanism that triggers edema after pneumonectomy. We emphasize that measurement of effective pulmonary capillary pressure allows for more accurate assessment of the hemodynamic status of such patients than does the measurement of wedge pressure.
本文描述了3例肺切除术后肺水肿病例,术中使用Swan-Ganz导管监测血流动力学稳定性。肺毛细血管压力的测量基于肺动脉闭塞曲线。所有3例患者均观察到高毛细血管压力和正常楔压,提示肺切除术后由于血流过多导致的净滤过压升高是引发肺水肿的致病机制。我们强调,与楔压测量相比,有效肺毛细血管压力的测量能够更准确地评估此类患者的血流动力学状态。