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[Pulmonary circulatory amputation in chronic respiratory insufficiency. Simple, anodyne, and fast evaluation]
1Service d'Insuffisance Respiratoire, La Musse, 27180 Saint-Sébastien de Morsent.
Unlabelled:
In chronic respiratory insufficiency, vascular bed amputation is a key element of the prognosis. The assessment of the carbon monoxide transfer capacity of the lungs is often impossible for technical reasons. However, the measurement of CO uptake (VCO), normalized by the reject of CO2 (VCO2) is a straightforward and repeatable measure for most healthy individuals. Its deficit is most likely due to either a circulatory impairment of the "gas-exchanging organ" and/or an alveolary ventilation failure.
Aim:
To define the relationship between hypoxemia and VCO/VCO2 deficit.
Method:
The subjects were classified into four causes of the disease: pneumonectomy, kyphoscoliosis, emphysema and chronical bronchitis. VCO/VCO2 was measured with an open circuit and simultaneous arterial blood-gas analysis.
Results:
With a few exceptions, VCO/VCO2 deficit was always observed and more important that hypoxemia. VCO/VCO2 and PaO2 values were not related in the case of emphysema, but strongly correlated and proportionally impaired in both pneumonectomy and kyphoscoliosis cases.
Conclusion:
This rapid, simple and well-tolerated measurement of VCO/VCO2 could provide a much-improved method of prognosis over the current CO measures.