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下空靜脈의 遮斷이 肺水鍾에 미치는 影響에 관한 硏究

EFFECTS OF RESTRICTION OF VENOUS RETURN BY THE BLOCKING OF THE INFERIOR VENA CAVA UPON PULMONARY EDEMA

대한의학협회지 1969년 12권 12호 p.1065 ~ 1076
李時來, 朴熙明,
소속 상세정보
李時來 (  ) - 慶北大學校 醫科大學 內科學敎室
朴熙明 (  ) - 慶北大學校 醫科大學 內科學敎室

Abstract

An experimental study was made on the effects of restriction of venous return by the occlusion of the inferior vena cava upon lung/body weight ratio, production of pulmonary edema and cardiopulmona교 functions on dogs given a large amount of normal saline. In this study 43 mongrel dogs were divided into two groups, namely control and experimental groups. In both groups, immediately after basal observations on cardiopulmonary functions were made 200 ml./kg. of normal saline was rapidly infused via pulmonary artery and femoral vein. In the experimental group, 30 minutes after the completion oft he saline infusion, occlusion of the inferior vena cava below the renal veins was produced by means of inflation of the balloon attached to the tip of a catheter. Another measurement on the cardiopulmonary functions was made 90 minutes after the infusion in both groups and followed by postmortem examination.
The majority of the dogs in the control group developed Jordan´s grade 1 to 3 pulmonary edema, whereas in the experimental group, Jordan´s grade C to 1 pulmonary edema. The lung/body weight ratio was significantly lower in the experimental group than in the control group. These facts denote that the blocking of the inferior vena cava was effective for the treatment of pulmonary edema produced by the infusion of a large quantity of saline.
The heart rate was significantly decreased both in control and experimental groups, and the caroutput was markedly increased in the former, whereas it was greatly decreased in the latter.
The femoral artery mean pressure and total periresistance were decreased in both groups, and the decrease in the total peripheral resistance was more pronounced in the control group. The difference in the peripheral reistance between the twogroups was thought to have resulted from the difference in the cardiac output.
The pulmonary artery mean pressure and total pulmonary resistance also showed marked decrease in both groups and the decrease in the total pulmresistance was more marked in the experigroup.
The diastolic pressure of the right ventricle showed no remarkable changes in both groups.
The systolic pressure also showed no significant change in the control group, but it was considerably decreased in the experimental group.
Respiratory rate, tidal volume, minute ventilation, ventilation equivalent, arterial respiratory gases revealed no difference between the control and experimental groups.
The arteriovenous oxygen difference was increased in both groups, being more marked in the experimental group. Oxygen consumption and carbon dioxide elimination were significantly increased in the control group but these in the experimental group showed no significant changes. These differences between the two groups were thought to be due to the difference in the cardiac output between the control and the experimental groups.

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