在Fontan型手术后晚期的基础肺血管阻力和氧化反应能力
S Khambadkone1, J Li, M R de Leval
1Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK. s.khambadkone@ich.ucl.ac.uk
Circulation
|June 25, 2003
概括
在Fontan患者中,肺血管抵抗 (PVR) 与氧化 (NO) 降低,这表明由于肺血流变化导致的内皮功能障碍. 对NO增强疗法的进一步研究是有必要的.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 肺高血压是什么意思 肺高血压
背景情况:
- 脉动性肺血流对于氧化 (NO) 释放和降低肺血管阻力 (PVR) 至关重要.
- 喷泉式操作会破坏正常的脉动流,但对PVR和NO响应的晚期影响尚不清楚.
研究的目的:
- 评估基底PVR及其对外源NO的响应能力在Fontan类型手术患者中.
- 为了研究这些患者潜在的肺内皮功能障碍.
主要方法:
- 索引PVR (PVRI) 用Fick原理和呼吸道质谱法进行测量.
- 15名患者 (平均年龄为12岁) 接受了NO吸入 (20ppm 10分钟).
- 患者在Fontan手术后的中位数为9年后被评估.
主要成果:
- 基础PVRI为2.11+/-0.79 WU*m2,在NO吸入后显著降低至1.61+/-0.48 WU*m2 (P=0.016).
- 患有非脉动性流动的患者在NO后显示PVRI从2.18+/-0.34降低到1.82+/-0.55 WU*m2.
结论:
- 外源的NO显著降低了PVR在Fontan类型操作后的晚期.
- 这些发现表明肺内皮功能障碍,可能与改变的,非脉动性流动特征有关.
- 旨在增强肺内皮NO释放的治疗策略可能有利于这些患者.
相关概念视频
Acute Respiratory Failure-II
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Pneumothorax-I
A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Mitral Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Mitral Stenosis IV: Nursing Management
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Atelectasis II: Pathophysiology
Atelectasis develops when alveoli lose their air and collapse inward. Because lung tissue is naturally elastic, these air sacs shrink rather than remaining open. Collapsed alveoli are no longer ventilated, reducing their role in gas exchange. Blood flow may continue in these regions, creating a ventilation–perfusion mismatch. Clinical findings include decreased breath sounds, dullness to percussion, reduced chest expansion, and decreased tactile fremitus as sound transmission through collapsed...


