대한핵의학회지 (The Korean Journal of Nuclear Medicine)

대한핵의학회 (The Korean Society of Nuclear Medicine)
권호 표지

호흡부전증에세 호기말 양압호흡법 치료 전후의 폐혈류역학적 변화에 관한 연구

A Study on the Pulmonary Hemodynamic Changes before and after PEEP in ARDS

  • 정준기 (서울대학교 의과대학 내과학교실) ;
  • 신성해 (서울대학교 의과대학 내과학교실) ;
  • 강신광 (서울대학교 의과대학 내과학교실) ;
  • 박성기 (서울대학교 의과대학 내과학교실) ;
  • 이명철 (서울대학교 의과대학 내과학교실) ;
  • 조보연 (서울대학교 의과대학 내과학교실) ;
  • 고창순 (서울대학교 의과대학 내과학교실) ;
  • 김용락 (서울대학교 의과대학 마취과학교실) ;
  • 김광우 (서울대학교 의과대학 마취과학교실)
  • Chung, June-Key (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Shin, Seong-Hae (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Khang, Shin-Kwang (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Park, Sung-Ki (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Lee, Myung-Chul (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Cho, Bo-Youn (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Koh, Chang-Soon (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Kim, Yong-Lack (Department of Anesthesiology, College of Medicine, Seoul National University) ;
  • Kim, Kwang-Woo (Department of Anesthesiology, College of Medicine, Seoul National University)
  • 발행 : 1984.11.22
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초록

The purpose of this study is to observe the changes of pulmonary capillary permeability and various hemodynamic parameters before and after Positive End-Expiratory Pressure(PEEP) in Adult Respiratory Distress Syndrome (ARDS). Using a canine oleic acid induced ARDS model, we measured the pulmonary capillary permeability with a slope of lung: heart radioactivity ratio, hemodynamic parameters with Swan-Ganz catheter and blood gas tensions. 1) In normal and ARDS dogs, the PEEP didn't significantly influence the slope of lung: heart radioactivity ratio. But in ARDS group the slope index was increased compaired with that of control group (p<0.05). 2) Also in ARDS group, $PaO_2$ was significantly decreased, and $PaCO_2,\;PvCO_2$, MPAP, $AaDO_2$, Qs/Qt were significantly increased compared with those of control group (p<0.05). 3) In normal dogs, the PEEP didn't influence blood pH or gas tension, $AaDO_2$, Qs/Qt, or hemodynamics. 4) In ARDS dogs, however, the PEEP significantly increased $PaO_2$ and decreased $AaDO_2$, Qs/Qt (p<0.05).

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