| Increased pulmonary venous resistance in morbidly obese patients without daytime hypoxia: clinical utility of the pulmonary artery catheter. | |
| | |
MedLine Citation:
|
PMID: 20683252 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The pulmonary artery (PA) diastolic-pulmonary capillary wedge pressure (PAD-PCWP) gradient has been shown to be increased in morbidly obese patients without daytime hypoxia. In sepsis, the increased pulmonary venous resistance (PvR) contributes to increases in PAD-PCWP gradient. In addition, the obesity-related endotoxemia is known to be involved in the pathophysiology of metabolic syndrome in obesity. Therefore, it is possible that the increased PvR contributes to increases in PAD-PCWP gradient in morbid obesity. We examined this possibility. METHODS: Included were 25 obese patients without daytime hypoxia undergoing bariatric surgery under general anesthesia. PvR was calculated as the difference between mean PA output pressure and PCWP divided by cardiac index. Mean PA output pressure was computed from the harmonic form of the recorded PA pressure by applying an attenuating factor to its phasic components, for which Fourier analysis was used. Total pulmonary vascular resistance (TPVR) was calculated as the difference between mean PA pressure and PCWP divided by cardiac index. To avoid the effect of PA resistance on TPVR and PvR, the PvR/TPVR ratio was used. RESULTS: There was a good correlation between PvR/TPVR ratio and PAD-PCWP gradient (r2=0.785, P<0.0001). When patients were divided into two groups based on PAD-PCWP gradient, the PvR/TPVR ratio was 0.67+/-0.06 (mean+/-SD) in the group with a PAD-PCWP gradient of at least 6 mmHg and 0.48+/-0.05 in the other group (P<0.0001). CONCLUSIONS: A strong correlation between PvR/TPVR ratio and PAD-PCWP gradient suggests that the increased PvR contributes to increased PAD-PCWP gradient in obese patients without daytime hypoxia. |
| | |
Authors:
|
Charles Her; Thomas Cerabona; Seung-Hoon Baek; Sang-Wook Shin |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Anesthesiology Volume: 113 ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2010 Sep |
Date Detail:
|
Created Date: 2010-08-27 Completed Date: 2010-09-24 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
|
Languages: eng Pagination: 552-9 Citation Subset: AIM; IM |
Affiliation:
|
Department of Anesthesiology, Pusan University, Yangsan Hospital, Yangsan, Gyeongnam, Korea. charles6133@msn.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Anesthesia, General / methods Anoxia* / physiopathology Catheterization, Peripheral* / methods Female Humans Male Middle Aged Obesity, Morbid / physiopathology*, surgery Pulmonary Artery / physiology* Pulmonary Veins / physiology* Pulmonary Wedge Pressure / physiology Vascular Resistance / physiology* Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Effects of Preoxygenation on Desaturation Time during Hemorrhagic Shock in Pigs.
Next Document: Potential Influence of the Anesthetic Technique Used during Open Radical Prostatectomy on Prostate C...