ABSTRACT
12 patients (9 males, 3 females; aged 35-63 years, mean 55) with chronic obstructive pulmonary disease (COPD) were studied in order to determine the correlation between the values of pulmonary arterial pressure and the M-mode echographic size of the right pulmonary artery (RPA) from the subxiphoid approach. Both the largest (systolic) and smallest (diastolic) size of the vessel were considered, and both were corrected for body surface area ('index size' - PA/BSA). The reliability of this echographic size is supported by the evidence that the tract of the pulmonary artery considered in this study is perpendicular to the ultrasonic beam. Both the systolic and diastolic size of RPA correlated with the systolic, diastolic, and mean pulmonary arterial pressure, detected by catheterization. Measurements of RPA size were made from the suprasternal approach in 8 patients out of 12. The size of RPA from the subxiphoid approach was also estimated in 21 normal subjects, serving as controls. Measurements of RPA size from the suprasternal approach were made in 12 of these subjects. Both the systolic and diastolic size of RPA from the subxiphoid approach correlated with the systolic and diastolic size of the suprasternal view in patients and in normal subjects. Subxiphoid M-mode echocardiography seems to be a valuable noninvasive technique in assessment of pulmonary hypertension, particularly in patients affected by COPD.
Subject(s)
Echocardiography , Hypertension, Pulmonary/diagnosis , Lung Diseases, Obstructive/complications , Adult , Aged , Cardiac Catheterization , Female , Humans , Hypertension, Pulmonary/etiology , Hypertension, Pulmonary/physiopathology , Male , Middle AgedABSTRACT
Normovolemic hemodilution produced by isovolumetric venesection was done in 8 patients with polycythemia and respiratory failure secondary to chronic obstructive pulmonary disease. The 'deformability index' was studied by means of a filtration technique. The blood flow velocity in ascending aorta and right pulmonary artery was also studied by means of ultrasonic Echo-Doppler technique. The procedure showed in all patients an increase of oxygen tension and a decrease of carbonic gas tension in arterial blood. At the same time it was possible to demonstrate an improvement of red cell deformability and an increase of arterial flow velocity. Isovolumetric venesection is an important procedure in the management of patients with polycythemia secondary to respiratory failure.
Subject(s)
Arteries/physiopathology , Blood Viscosity , Erythrocytes, Abnormal/physiopathology , Polycythemia/etiology , Respiratory Insufficiency/physiopathology , Veins/surgery , Blood Flow Velocity , Chronic Disease , Humans , Respiratory Insufficiency/complications , Respiratory Insufficiency/surgeryABSTRACT
15 subjects, divided into (1) normal, (2) with small airway obstruction (SAO) and (3) with chronic obstructive lung disease (COLD), were studied to understand the mechanism of the obstruction. The curves of maximal expiratory flow versus static pressure are particularly useful for this purpose, when we have a SAO. In fact, only at this early stage, we can identify by this way two different groups: subjects obstructed by a pure extrinsic mechanism, and subjects obstructed by a pure intrinsic mechanism.
