Balloon Occlusion Pulmonary Angiography in Acute Respiratory Failure
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概要
- 論文の詳細を見る
We performed balloon occlusion pulmonary angiography (BOPA) with Swan-Ganz catheter to examine the angiographic morphology of the pulmonary peripheral vasculature in the patient with acute respiratory failure of diverse etiologies, including multiple pulmonary thromboembolism. To assess the BOPA findings we established six following BOPA indeces, i. e. (1) intraluminal filling defect or cut-off sign, (2) pruning of the arterial branches, (3) irregularity of vascular wall, (4) incomplete capillary filling, (5) tortuosity, (6) adjacent oligemia. In 6 of 8 patients with multiple pulmonary thromboembolism confirmed by perfusion lung scanning, standard pulmonary angiography and/or phlebography of the lower extremities 3 to 4 BOPA indeces were obtained. On the other hand, BOPA indeces were 0 to 2 in 26 of 38 remaining patients with other acute respiratory failure. The mortality rate due to respiratory failure of these 26 patients was 12 per cent, and that of 12 patients who had more than 3 BOPA indeces was 75 per cent (p<0.001). Pulmonary vascular resistance was higher in those with 3 or more BOPA indeces than those with 0 to 2 BOPA indeces, however, there was no significant difference. Pulmonary histologic specimens from patients with 3 to 5 BOPA indeces showed marked interstitial pneumonitis of diverse etiologies with collapsed capillary beds, organized thrombi, and proliferation of the endotherial cells of the small muscular artery. These results suggest that the BOPA indeces are reliable and specific means of making diagnosis of pulmonary vascular occlusive lesions in patients with acute respiratory failure and valuable tool for the prognostic index.
- 北里大学の論文
- 1987-04-30
著者
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Soma Kazui
Department Of Internal Medicine And Critical Care And Emergency Medicine Kitasato University School
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Tomita Tomoyuki
Department Of Internal Medicine And Critical Care And Emergency Medicine Kitasato University School
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KATAGIRI Masato
Department of Respiratory Medicine, Kitasato University School of Medicine
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Yanase Nobuo
Department Of Internal Medicine And Critical Care And Emergency Medicine Kitasato University School
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Soma Kazui
Department Of Critical Care And Emergency Kitasato University School Of Medicine
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Katagiri Masato
Department Of Clinical Physiology School Of Allied Health Sciences Kitasato University
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Katagiri Masato
Department Of Internal Medicine And Critical Care And Emergency Medicine Kitasato University School
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