体位変換時における肺循環動態 : 45度体位変扱における肺循環と呼吸機能の変化について
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概要
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The pulmonary artery pressure response to 45 degrees tilting of the body was studied by Mise et al., and the results were previously reported in special reference to the differential diagnosis of mitral stenosis and insufficiency In this paper the changes of hemodynamics of the pulmonary circulation studied on patients with cardiac or pulmonary disease are presented Subjects and Methods Twenty three subjects were composed of 12 patients with mitral stenosis, 3 with mitral steno-insufficiency, 4 with mitral insufficiency, 2 with aortic insufficiency and 2 with bronchial asthma. Right heart catheterization was performed in the usual way. Resting systemic and pulmonary blood pressures and cardiac output were measured in recumbent position. Thereafter, the patient was tilted at an angle of 45 degrees, head up from the horizontal, by means of tilting an X-ray examination table. Recording of pulmonary blood pressures was started immediately after tilting and made intermilttently for a period of ten minutes. After 10 minutes, cardiac output was measured again. Reference zero point to measure the blood pressure was settled at the midpoint between the level of the angle of Louis and of the back in the supine position, and the same zero point was used in the tilted body position also, because of difficulties of the setting of reference point common to various body positions. Results I. Comparison between hemodynamics and blood gases in recumbent position and those at 10 minutes after the tilting 1. Change of the pulse rate was not constant and within a range from -24 to + 34 (average -0.8 decrease) per minute after the tilting. 2. Respiratory rate also did not show any constant change, which was within a range from - 11 to + 7 (average -0.5 fall) per minute after the tilting' 3. Arterial oxygen saturation increased slightly in all but 3 cases after the tilting, and the average increase was 3 per cent. 4. Arterial CO_2 tension slightly fell in all but 3 cases, and the average fall was 1.4 mmHg. 5. Cardiac index decreased in 15 of 17 cases. The value in recumbent position was n a range from 1.45 to 6.43 (average 3.63) L/min/M^2, and that at 10 minutes after the tilting was in a range from 1.20 to 6.03 (average 2.88) L/min/M^2. The change was within a range from -3.14 to +0.20 (average -0.75) L/min/M^2, which was 20 per cent fall.
- 社団法人日本循環器学会の論文
- 1963-08-20