高炭酸ガス血症の心肺動態 : とくに心拍出量に及ぼす影響に関する臨床的実験的研究
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The accumulation of carbon dioxide in the blood has often been observed in the patients with severe pulmonary disease. In these circumstances, an increased carbon dioxide might influence on the brain as well as heart and consequently cause oxygen deficiency in the brain associated with reduced cardiac out-put. The present studies were designed to test the pulmonary circulatory dynamics under the condition of acute induced hypercapnia in human subjects with pulmonary disease. On the other hand in animal experiment, the animals were examined under two times con-trolled hyperventilation than resting ventilation using a body respirator where their pulmonary circulatory dynamics were not influenced by the change of respiratory pattern. Method s 1) In human subjects Twenty patients with chronic obstructive pulmonary disease were examined for the pulmonary circulatory dynamics at 20 to 40 minutes after inhalation of 4.5 per cent of carbon dioxide. 2) In experimental animal Five healthy dogs were tested under two times controlled hyperventilation with air (hypocapnia), breathing 4 per cent of carbon dioxide (isocapnia), and 10 per cent of carbon dioxide (hypercapnia) in a body respirator of our design. Results A) In human subjects 1) There were no marked change in the wedge pressure of pulmonary artery by breath-ing 4.5 per cent of carbon dioxide with the exception of 3 cases. The mean pressure of pulmonary artery slightly increased from 17.1 to 19.2 mmHg, however, no cases rose as high as above threshold value of 40 mmHg. The pressure of the right ventricle increased in 18 patients, and inthe remaining 2 cases the pressure was unchanged. The mean value of end-diastolic pressure was increased by 2.8mmHg. 2) Before inhalation, the mean cardiac index of these patients was slightly higher than that of normal subjects, the average value being 4.05 l/min/m^2. After inhalation, 12 of 19 patients showed decreased values. Almost all decreased cases already had hypercapnia before inhalation, otherwise showed hypercapnia after inhalation and a rise in end-diastolic pressure of the right ventricle was observed.
- 社団法人日本循環器学会の論文
- 1967-04-20
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- 高炭酸ガス血症の心肺動態 : とくに心拍出量に及ぼす影響に関する臨床的実験的研究