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급성폐손상환자에서 호기말양압의 변화가 폐모세혈관압에 미치는 영향

Other Titles
 The Effect of Positive end Expiratory Pressure on the Pulmonary Capillary Pressure in Acute Lung Injury Patients 
 정병천  ;  변창규  ;  이창률  ;  김형중  ;  안철민  ;  김성규  ;  신중수 
 Tuberculosis and Respiratory Diseases (결핵 및 호흡기질환), Vol.49(5) : 594-600, 2000 
Journal Title
Issue Date
Acute lung injury ; Positive end expiratory pressure ; Pulmonary capillary pressure
Background : Positive end expiratory pressure (PEEP) ventilation is well established as an integral part of the management of patients with the acute lung injury. PEEP is a key element in the treatment of hypoxemia resulting from pulmonary edema. Pulmonary capillary pressure (Pcap) is the most important factor influencing lung edema formation, and an understanding of how Pcap is altered by variations of PEEP or pulmonary arterial occlusion pressure (PAOP) is important to improve the treatment of acute lung injury patients. This study was performed to evaluate the effects of PEEP on the pulmonary capillary pressure in acute lung injury patients. Methods : This was a prospective study of 11 acute lung injury patients. The effect of PEEP on pulmonary circulation at four different levels (0,4,8, and 12cmH2O) was analyzed. Pcap was estimated visually at bed side with Swan Ganz catheters. The pulmonary vasculature was analyzed by calculating the pressure difference at the arterial and venous parts of the circulation. Results: As PEEP increased from 0 to 12 cmH2O, the mean pulmonary arterial pressure (PAP) and Pcap increased respectively from 22.7pm7.4 to 25.3pm7.3 mmHg and 15.3pm3.3 to 17.8pm3.2 mmHg (p<0.05). Similarly, PAOP increased from 9.8pm2.1 to 12.8pm2.1 mmHg and the central venous pressure increased from 6.1pm1.6 to 9.3pm2.3 mmHg(p<0.05). However, the pressure gradient at the arterial (PAP-Pcap) and venous (Pcap-Pcwp) parts of pulmonary circulation remained unchanged at all evaluated PEEP levels. Conclusion : Although Pcap increased gradually with increased the pressure gradient at the arterial and venous part of the pulmonary vasculature remained unchanged at all evaluated PEEP levels in acute lung injury patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyung Jung(김형중) ORCID logo https://orcid.org/0000-0003-2498-0683
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