Effects of Positive End-Expiratory Pressure Ventilation and Extracorporeal Ultrafiltration Method in Patients with Refractory Heart Failure : PANEL DISCUSSION ON PUMP FAILURE OF THE HEART WITH COMPLICATIONS : 49th Annual Scientific Session of the Japanese
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概要
- 論文の詳細を見る
We studied the effects of positive end-expiratory pressure (PEEP) ventilation in ten patients with acute myocardial infarction (nine in Killip class III, one in Killip class IV; pulmonary capillary wedge pressure > 24 mmHg) and of extracorporeal ultrafiltration method (ECUM) in seven patients with refractory heart failure due to acute myocardial infarction and others. (1) Application of PEEP resulted in significant increases in PaO_2 and SaO_2 and decrease in PaCO_2. Significant reduction in mean pulmonary arterial and pulmonary capillary wedge pressures and heart rate was observed, while stroke work index increased significantly. There was a significant correlation between changes in stroke work index and PaO_2 after the application of PEEP. (2) The use of ECUM removed fluid of 1416 ± 662 ml (680-2800 ml) with the ultrafiltration flux rate being 478 ± 223 ml/hour. Significant decreases in mean pulmonary arterial, pulmonary capillary wedge and central venous pressures were observed, while PaO_2 increased significantly. BUN and serum creatinine levels increased significantly, and total protein and serum albumin tended to increase. There was a significant correlation between fluid removed and change in PaO_2 after the use of ECUM. Thus, PEEP and ECUM are beneficial for patients with refractory heart failure. The mechanism(s) are: (1) reduction in preload due to an increased intrathoracic pressure and a decreased systemic venous return with PEEP, or due to removal of excess fluid with ECUM, and (2) improvement of the oxygenation of the blood.
- 社団法人日本循環器学会の論文
- 1986-04-20
著者
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Nitta Takashi
Division Of Cardiovascular Surgery Nippon Medical School
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Takano Teruo
Division of Cardiology, Hepatology, Geriatrice, and Integrated Medicine, Nippon Medical School
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Tanaka Keiji
Division of Intensive and Coronary Care Unit, Nippon Medical School
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Endo Takao
First Department Of Internal Medicine Nippon Medical School
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Hayakawa Hirokazu
The First Department Of Medicine Nippon Medical School
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Hayakawa Hirokazu
Internal Medicine Department Of Cardiology Nippon Medical School
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ENDO TAKAO
Nippon Medical School Hospital
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Nitta Takashi
The Department Of Cardiovascular Surgery Nippon Medical School
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KOH Mototetsu
Division of Department of Internal Medicine,Nippon Medical School
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Hayakawa Hirokazu
Nippon Medical School, Tokyo
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SElNO Yoshihiko
Division of CCU and ICU, Nippon Medical School
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ENDO TAKAO
Division of CCU and The First Department of Internal Medicine
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MATSUYAMA YUZURU
Division of CCU and The First Department of Internal Medicine
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Koh Mototetsu
Division Of Ccu And The First Department Of Internal Medicine
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Nitta Takashi
Department Of Cardiovascular Surgery Nippon Medical School
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Hayakawa Hirokazu
Nippon Medical School
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Nitta Takashi
Department Of Biological Regulation And Regenerative Surgery Nippon Medical School Graduate School O
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Nitta Takashi
Department Of Cardiothoracic Surgery Nippon Medical School
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Takano Teruo
Division Of Cardiology Department Of Medicine Nippon Medical School
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Koh Mototetsu
1st Department Of Internal Medicine And Ccu Nippon Medical School
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Tanaka Keiji
Division Of Cardiology Department Of Internal Medicine Nippon Medical School
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Matsuyama Yuzuru
Department Of Medicine (ccu & Icu) Nippon Medical School
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Matsuyama Yuzuru
Division Of Cardiology And Cardiac Surgery Kofu Johnan Hospital
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Selno Yoshihiko
Division Of Ccu And Icu Nippon Medical School
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Koh Mototetsu
Division Of Cardiology Inadanoborito Hospital Kawasaki
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Nitta Takashi
Division of Cardiology, and Cardiovascular Surgery, Nippon Medical School
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