Essay on pulmonary resistance

Submitted By alreemy
Words: 736
Pages: 3
Open Document
196

Scientific Letter

Evaluation of pulmonary vascular resistance and vasoreactivity testing with oxygen in children with congenital heart disease and pulmonary arterial hypertension
Ayhan Çevik, Serdar Kula, Rana Olguntürk, Sedef Tunaoğlu, Deniz Oğuz, Berna Saylan1, Cihat Şanlı2
Department of Pediatric Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey
1Department of Pediatric Cardiology, Dışkapı Children’s Hospital; Ankara-Turkey
2Department of Pediatric Cardiology, Faculty of Medicine, Kırıkkale University; Kırıkkale-Turkey

Estimating pulmonary vascular resistance index (PVRI) is of critical importance in determining the type of cardiac surgery, the decision to perform heart transplantation, the choice between surgery and drug treatment or combined modalities, even though it is not the only criterion for judgment (1, 2). A positive pulmonary vasoreactivity test (PVT) is accepted as an indicator of low perioperative risk and good prognosis. An acute positive response to PVT is reported in only 40% of patients (3). This test has been applied in many centers, following different protocols and different evaluation criteria. Most centers use nitric oxide (NO) or oxygen (O2) inhalation, iloprost nebulization, or a combination thereof. A reduction by 20% of mean pulmonary artery pressure
(PAPmean) or in the ratio of pulmonary resistance to systemic vascular resistance index (PVRI/SVRI) will define the patient as being a “responder” (4, 5). Reports on PVT performed with different drugs have been published recently (5-8). The aim of this study was to define the hemodynamic parameters of patients undergoing cardiac catheterization in our center for congenital heart disease and pulmonary arterial hypertension (PAH), characterize the efficacy of O2 use in the PVT, and present the clinical findings in these patients with congenital intracardiac shunts. The present study was conducted on a cohort of 30 children diagnosed with PAH and congenital intracardiac shunts and placed under close surveillance at the pediatric cardiology department of the study center between October 2009 and
November 2011 (Table 1). As described previously the criteria used for PAH definition and patient selection were considered as mean pulmonary arterial pressure (PAPmean) of ≥25 mm Hg, pulmonary capillary wedge pressure (PCWP) of ≤15 mm Hg, and
PVR index (PVRI) of > 3 WU/m2 at rest (6). The PVRI was calculated conventionally as the ratio of the difference between PAP and left atrial pressure or the pulmonary capillary wedge pressure to mean pulmonary flow, and the values were expressed as

units per square meter. These parameters were also obtained before and after pulmonary vasoreactivity testing using 100% O2 by simple face mask for 10 min when a high PAPmean was suspected. The PVT was considered positive if PAPmean or the
PVRI/SVRI ratio exhibited a reduction by more than 20% (7, 8).
Patients were evaluated in two groups according to PVT results, responders and non-responders (Table 2). The median age, height, weight, body surface area (BSA) and heart rate of the recruited patients were respectively 20.0 months, 76.5 cm, 9.2 kg, 0.41 m2 and 112.0 beats/min. No significant difference was found in systolic PAP
Show More

Related Documents: Essay on pulmonary resistance

Baroreceptors In The Cardiovascular System

peripheral resistance, and therefore lower the mean arterial blood pressure. In a situation of someone who has chronic high blood pressure, the set points in the baroreceptor reflex would raise permanently and begin to act as though the high blood pressure set point is the new normal in the body. This is how chronic high blood pressure is unable to reverse by itself, due to high set points in the baroreceptor reflex. An example of a form of chronic high blood pressure the disease Pulmonary Hypertension…

Words 850 - Pages 4

The Human Respiratory System

Human ventilation such as Pulmonary ventilation, alveolar ventilation and machine ventilation is one of the biggest factors of the human body. Without ventilation which is breathing human life would not exist.. Pulmonary Ventilation is commonly known as breathing. It is the process of airflow into the lungs. Alveolar Ventilation refers to the amount of gases that reaches the alveoli during a breath. Inspiration and expiration, during each cycle a volume of gases moves in and out of the respiratory…

Words 650 - Pages 3

Circulation And Blood Flow

Circulation & Blood Pressure || Blood Pressure | Resistance | Capillary Exchange | Change in active tissues|| Interaction b/w cardiac output and capillary blood flow depends on Pressure, P, and Resistance, R. Inc. Pressure = Inc. Flow, and Inc. Resistance = Dec. Flow Pressure gradient is the difference in Pressure from one end of the vessel to the other Mean blood pressure decreases as you move away from the heart Resistance in the Venous system is very small and is thus able to return blood to…

Words 804 - Pages 4

Obstructive Lung Disease

RS L17 Obstructive lung disease Def: A decrease in the exhaled air flow caused by acute or chronic narrowing or blockage of the airways causing increased resistance to airflow. This obstruction is usually progressive, not fully reversible and does not change markedly over several months. The most common group of COPD include chronic bronchitis, emphysema and small airway disease. COPD is predominantly caused by smoking. Airflow obstruction is defined as a reduced FEV (volume of air that can be expelled…

Words 766 - Pages 4

Emphysema Case Study

they collapse the patient is not getting enough oxygen (Mosenifar, 2016). Furthermore emphysema is caused by a destruction of elastin and collagen in the pulmonary connective tissues that increase lung compliancy and cause permanent enlargement of air sacs at the distal end of bronchioles and rupture of alveoli. This increases airway resistance which is the opposition of the tissues of the air passages to the air flow (Boka, 2014).…

Words 475 - Pages 2

Essay about Respiratory Conditions

Respiratory Conditions Diagnostic Tests Pulmonary angiography: sensitive and specific test for PE. Invasive; insert catheter through AC or femoral vein and into pulmonary artery to inject contrast medium. Spiral (helical) CT scans: used to diagnosis pulmonary embolism. Ventilation-perfusion (V/Q) lung scan: IV radiosotope given to assess perfusion, inhaled radioactive gas to assess perfusion; ventilation without purfusion suggests pulmonary embolus. Performed if patient cannot have CT scans…

Words 1236 - Pages 5

Essay On Pediatric Intubation

Pediatric intubation refers to the process of managing the airway of a pediatric patient. It entails putting a tube into a canal, cavity, or hollow organ to maintain an open airway, permit drainage, and to administer either aesthetics or oxygen. The procedure is mainly done during airway management in order to alleviate obstruction and ensure adequate ventilation in the respiratory system of an infant. It is usually done as the top most priority activity in the management and care of pediatric patients…

Words 1434 - Pages 6

Adult Health III Essay

toxic Myocardial degeneration Early Manifestations: Tachycardia, hypotension, narrowed pulse pressure, increased SVR, increased myocardial O2 consumption PE Findings: Tachypnea, pulmonary congestion, crackles Increase in pulmonary artery wedge pressure (PAWP) and pulmonary vascular resistance Signs and Symptoms of peripheral hypoperfusion: Renal blood flow, urine output Anxiety/delirium with impaired cerebral blood flow Distributive Shock Fluid shifted from central vascular space…

Words 688 - Pages 3

COPD Research Paper

Describe etiology Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. COPD patients often develop hyperinflation. Hyperinflation occurs due to expiratory flow limitation caused by reduced lungs’ elastic recoil and increased airway resistance. Hyperinflation increases during…

Words 450 - Pages 2

Case Study Sildenafil

July 2017. Retrieved 30 July 2017 Pulmonary arterial hypertension (PAH) is classically categorized into 4 different groups by WHO. WHO group 1 involves the narrowing or damage of the pulmonary blood vessels. WHO group 2 Pathogenesis in pulmonary hypertension due to left heart disease. WHO group 3 In pulmonary hypertension due to lung diseases and/or hypoxia. WHO group 4 is thought that the initial event is triggered by a blockage or narrowing of the pulmonary blood vessels with unresolved blood…

Words 1310 - Pages 6