体位変換が一側肺動脈閉塞試験(UPAO)に及ぼす影響について

概要

論文の詳細を見る
The unilateral pulmonary arterial occlusion (UPAO) test is employed preoperatively to evaluate cardiopulmonary function and determine whether patients can tolerate lung resection. Lung resection is generally performed with the patients in the lateral position. We therefore conducted the UPAO test in both the lateral position and supine position to assess how hemodynamic changes in the acute phase immediately after intraoperative ligation of the pulmonary artery would be predicted by UPAO parameters in both positions. The subjects were 14 lung cancer patients who were scheduled to undergo pneumonectomy or lobectomy between January 1996 and January 1998. They were 10 males and 4 females, and their mean age was 68.7 ± 11.4 years. Mean pulmonary artery pressure (Ppa), mean pulmonary arterial wedge pressure (Ppw), and cardiac output (CO) by the thermodilution method were measured in both the supine and the larteral position to estimate total pulmonary vascular resistance index (TPVRI) and pulmonary vascular resistance index (PVRI). The points selected for making the measurements were the mid-axillary line in the supine position and the spinal midline in the lateral position. Mixed venous blood and arterial blood samples were collected for blood gas analysis. The Ppa values in the supine and the lateral position during UPAO were 18.4 ± 5.7 and 16.6 ± 5.7 mmHg, respectively, TPVRI values were 516 ± 235 and 467 ± 211 dyne・sec・cm^<-5>・m^2, respectively, and the mixed venous blood gas values (PvO_2) were 36.8 ± 3.3 and 35.4 ± 3.2 mmHg (p<0.001), respectively. The TPVRI in the supine position during UPAO has conventionally been used to limit the indications for lung resection. This study showed that TPVRI in the supine position during UPAO may be a useful index for intraoperative management during lung resection, because it reflects pulmonary hemodynamics in the acute phase immediately after ligation of the pulmonary artery.
東京女子医科大学の論文
2000-12-25

体位変換が一側肺動脈閉塞試験(UPAO)に及ぼす影響について

スポンサーリンク

概要

著者

関連論文

スポンサーリンク