Document Detail


Noninvasive estimation of pulmonary arterial blood pressure in burned patients with acute respiratory failure.
MedLine Citation:
PMID:  1763649     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pulmonary arterial hypertension develops in acute respiratory failure and mostly an enhanced PADd-PCWP gradient has an important effect on the outcome of that complication. Considering that this critical state of septic burned patients may last for weeks, the long-term direct monitoring of pulmonary arterial blood pressure with indwelling Swan-Ganz catheter is impossible because of the high risk of endocarditis. Therefore, the aim of this study was to elaborate a noninvasive method to estimate the pulmonary arterial hypertension. Determination of cardiac index and pulmonary arterial blood pressure was carried out with Swan-Ganz catheter, P32 Statham transducer, cardiac output computers (Gould IM 1000, Marquette 7010). Extended systolic time interval measurements (with Medicor 661 polygraph completed by PC program package) were performed simultaneously in 7 burned patients (av. age 38.7 ys, means of TBS 38%) with acute respiratory failure at 38 occasions. The values of cardiac indices with the two methods were practically the same CI t = 3.4 +/- 1.21 1/min/m2 CI s = 3.1 +/- 1.10 1/min/m2; regression equation: CI s = 0.874 CIt + 0.135, r = 0.98, n = 38. Close correlations have been found between PAPm and PO2/FiO2 (r = 0.75), as well as between PAP values and some noninvasively measured hemodynamic data. Using these interrelations: 1) regression equations for PAPs., PAPm, PAPd, PCWP, PVRI were elaborated (r values: 0.855, 0.869, 0.681, 0.644, 0.817 respectively); 2) discriminant analysis with noninvasive parameters correctly classified the cases at critical PAPd-PCWP gradient (greater than 4 mm/Hg) in 84%. These results suggest that a continuous noninvasive hemodynamic and blood gas monitoring completed with a periodic bedside computer analysis of the PC-processed data for calculation of the pulmonary arterial pressure may be enough for the therapy during the long-term critical periods.
Authors:
K Szabó; G Jokkel; R Pick
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta physiologica Hungarica     Volume:  78     ISSN:  0231-424X     ISO Abbreviation:  Acta Physiol Hung     Publication Date:  1991  
Date Detail:
Created Date:  1992-02-07     Completed Date:  1992-02-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8309201     Medline TA:  Acta Physiol Hung     Country:  HUNGARY    
Other Details:
Languages:  eng     Pagination:  27-41     Citation Subset:  IM    
Affiliation:
Burn Center of Central Military Hospital, Budapest, Hungary.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Blood Gas Analysis
Blood Pressure / physiology
Blood Pressure Determination / instrumentation,  methods*
Burns / complications,  physiopathology*
Cardiac Output / physiology
Catheterization
Electrocardiography
Heart Rate / physiology
Humans
Hypertension, Pulmonary / diagnosis*,  etiology
Male
Middle Aged
Oxygen Consumption / physiology
Pulmonary Artery / physiopathology*
Pulmonary Circulation / physiology
Respiratory Function Tests
Respiratory Insufficiency / etiology,  physiopathology*
Thermodilution

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


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