PULMONARY GAS EXCHANGE IN ACUTE MYOCARDIAL INFARCTION WITH LOW PULMONARY CAPILLARY WEDGE PRESSURE

概要

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To evaluate the clinical characteristic of pulmonary gas exchange in patients with low pulmonary capillary wedge pressure (PCW<18mmHg) in the early phase of acute myocardial infarction. we investigated 48 patients admitted with-in 24h from the onset of chest pain. The alveolar-arterial oxygen tension difference (AaDO_2) and arterial blood gas parameters were obtained while breathing room air on admission. The disturbance of pulmonary gas exchange. as revealed by the high value of AaDO_2, existed without left ventricular dysfunction. and AaDO_02 had no significant relationship with any of the hemodynamic para-meters including the difference between plasma colloid osmotic pressure and PCW. Multiple regression analysis was performed using 9 variables related to pulmonary gas exchange, to identify those which were important. As a result. QRS score (p<0.01) and age (p<0.05) were identified as significant variables related to AaDO_2. Thus. the disturbance of pulmonary gas exchange in patients with low PCW was caused by mechanisms other than left ventricular failure which may reflect the extent of ischemic myocardium.
社団法人日本循環器学会の論文
1991-02-20