A Study on the Postoperative Hemodynamic and Respiratory Changes following Pulmonary Thromboendarterectomy for Chronic Pulmonary Thromboembolism
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概要
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We investigated hemodynamic and respiratory changes in 19 postoperative patients who had undergone thromboendarterectomy for chronic pulmonary thromboembolism (CPTE) between 1986 and 1993 and were managed in our ICU. The postoperative hemodynamic and respiratory studies revealed reduced mean pulmonary arterial pressure (mean PAP), increased cardiac index (CI), and a resultant significant reduction in pulmonary vascular resistance (PVR) compared to their preoperative values. However, arterial oxygen tension (PaO2) deteriorated and the respiratory index (RI) increased on the admission to ICU. We classified these patients into two groups according to the duration of ventilatory support: group A required 5 or more days for weaning from the ventilator and group B were weaned from the ventilator within 5 days. The percent changes in mean PAP and PVR were greater in group A than in group B. The deteriorations in respiratory condition observed during the immediate postoperative period were supposed due to the ventilation-perfusion imbalance following the sudden reliease of mechanical obstruction caused by the removal of the thromboemboli. However, the patients' postoperative respiratory condition gradually improved in both groups and the difference had vanished by the 7th postoperative day. The preoperative hemodynamic findings, especially PVR, were worse in the non-survivors than that in the survivors, indicating that the preoperative PVR is a determinant factor of outcome.
- 一般社団法人 日本集中治療医学会の論文
一般社団法人 日本集中治療医学会 | 論文
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