Sari A, Okuda Y, Takeshita H, Oda T
Anesth Analg. 1976 May-Jun;55(3):315-21. doi: 10.1213/00000539-197605000-00006.
Intrapulmonary shunt, cardiac output, and O2 consumption as factors contributing to alveolar-arterial O2 tension difference (A-aDo2) were tested in 11 patients after open-heart surgery. A-aDo2 was well correlated with intrapulmonary shunt, as expected, but no correlation was found between cardiac index (CI) and intrapulmonary shunt. When total shunt (venous admixture) was above 11%, there was an inverse correlation between A-aDo2 and CI, and it was observed that CI falling below 2.5 L/min/sq m contributed significantly to the enlargement of A-aDo2. Low Pao2 (less than 65 torr, breathing air) was characterized by larger arterial-mixed venous O2 content difference than high Pao2 (is greater than 65 torr, on room air), indicating that A-aDo2 was influenced by cardiac output relative to metabolic demand. Intrapulmonary shunt played a main role in increasing A-aDo2 after open-heart surgery, and systemic factors, including changes in cardiac output and O2 consumption, also contributed to development of hypoxia.
对11例心脏直视手术后的患者，测试了肺内分流、心输出量和氧耗作为导致肺泡-动脉血氧分压差（A-aDo2）的因素。正如预期的那样，A-aDo2与肺内分流密切相关，但未发现心脏指数（CI）与肺内分流之间存在相关性。当总分流（静脉血掺杂）超过11%时，A-aDo2与CI呈负相关，并且观察到CI降至低于2.5L/（min·m²）会显著导致A-aDo2增大。低氧分压（呼吸空气时低于65托）的特征是动脉血-混合静脉血氧含量差大于高氧分压（室内空气时高于65托），这表明A-aDo2受相对于代谢需求的心输出量影响。肺内分流在心脏直视手术后增加A-aDo2方面起主要作用，包括心输出量和氧耗变化在内的全身因素也促成了缺氧的发生。
