Document Detail


Myocardial perfusion as assessed by thallium-201 scintigraphy during the discontinuation of mechanical ventilation in ventilator-dependent patients.
MedLine Citation:
PMID:  2042755     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients who cannot be separated from mechanical ventilation (MV) after an episode of acute respiratory failure often have coexisting coronary artery disease. The authors hypothesized that increased left ventricular (LV) wall stress during periods of spontaneous ventilation (SV) could alter myocardial perfusion in these patients. Using thallium-201 (201TI) myocardial scintigraphy, the authors studied the occurrence of myocardial perfusion abnormalities during periods of SV in 15 MV-dependent patients (nine women, six men; aged 71 +/- 7 yr, mean +/- SD). Fourteen of these patients were studied once with 201TI myocardial scintigraphy during intermittent mechanical ventilation (IMV) and again on another day, after at least 10 min of SV through a T-piece. One patient was studied during SV only. Thirteen of 14 of the patients (93%) studied during MV had abnormal patterns of initial myocardial 201TI uptake, but only 1 patient demonstrated redistribution of 201TI on delayed images. The remainder of the abnormalities observed during MV were fixed defects. SV produced significant alterations of myocardial 201TI distribution or transient LV dilation, or both, in 7 of the 15 patients (47%). Four patients demonstrated new regional decreases of LV myocardial thallium concentration with redistribution of the isotope on delayed images. The patient studied only during SV also had myocardial 201TI defects with redistribution. Five patients (3 also having areas of 201TI redistribution) had transient LV dilation during SV.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
W E Hurford; K E Lynch; H W Strauss; E Lowenstein; W M Zapol
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Anesthesiology     Volume:  74     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1991 Jun 
Date Detail:
Created Date:  1991-07-11     Completed Date:  1991-07-11     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1007-16     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesia, Harvard Medical School, Massachusetts General Hospital, Boston 02114.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Coronary Circulation / physiology*
Female
Heart / radionuclide imaging*
Humans
Male
Middle Aged
Respiration Disorders / physiopathology*,  therapy
Respiration, Artificial*
Thallium Radioisotopes / diagnostic use*
Grant Support
ID/Acronym/Agency:
HL23591/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Thallium Radioisotopes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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