徳島大学 教育・研究者情報データベース(EDB)

1. 徳島大学.医学部.医学科.病態情報医学講座
2. 徳島大学.医学部.附属病院(〜2003年9月30日/->組織[徳島大学.病院.医科診療部門])

1. 川人 伸次([徳島大学.大学院医歯薬学研究部.歯学域.口腔科学部門.臨床歯学系.歯科麻酔科学])

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2. 北畑 洋

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3. 田中 克哉([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.麻酔・疼痛治療医学]/[徳島大学.病院.診療科.脳·神経·精神科])

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4. 野﨑 淳平

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5. 大下 修造

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(英) Transesophageal echocardiographic assessment of pulmonary arterial and venous flow during high-frequency jet ventilation.

(英) To evaluate high-frequency jet ventilation (HFJV) effects on pulmonary arterial and venous flow compared to those of intermittent positive-pressure ventilation (IPPV) by using pulsed Doppler transesophageal echocardiography. Prospective clinical study. University-affiliated hospital operating room.Patients: 13 ASA physical status I and II patients undergoing lower abdominal or lower extremity surgery. Patients had total IV anesthesia with propofol and fentanyl. After anesthesia induction, a transesophageal echocardiography probe was inserted into the esophagus. IPPV (TV, 8-10 mL/kg; respiratory rate, 10-12 cycles/min; I/E ratio, 1:2; FIO(2), 1.0) and HFJV (driving pressure, 0.5-0.6 kgf/cm(2); frequency,3 Hz; I/E ratio, 1:1; FIO(2), 1.0) were performed under hemodynamically stable conditions. Pulmonary-arterial-flow velocity, pulmonary-venous-flow velocity, left ventricular short-axis view, and airway-pressure curve were recorded simultaneously. Parameters measured were: hemodynamic variables, arterial blood gases, inspiratory airway pressure; [from pulmonary-arterial-flow velocity] pre-ejection period (PEP), acceleration time (AT), right ventricular ejection time (RVET), and their ratios (PEP/AT, AT/RVET); [from pulmonary-venous-flow velocity] time-velocity integral of the first systolic wave (S1), second systolic wave (S2), and diastolic wave (D), and systolic fraction (integral S1 + S2/S1+ S2 + D); [from M-mode] left-ventricular-end systolic volume, left-ventricular-end diastolic volume (LVEDV), stroke volume, cardiac output, and ejection fraction, using Teichholz's method. Peak inspiratory airway pressure during HFJV was significantly lower than that during IPPV. HFJV significantly decreased PEP/AT, correlating positively with pulmonary arterial pressure, and significantly increased AT and AT/RVET, correlating negatively with pulmonary arterial pressure. Systolic fraction, correlating negatively with left atrial pressure, increased significantly during HFJV, as did LVEDV, stroke volume, cardiac output, and ejection fraction. Our results suggest that, in comparison to IPPV, HFJV significantly decreases pulmonary arterial pressure and left atrial pressure, resulting in significant increases in cardiac output and ejection fraction in healthy anesthetized adults.

1. (英) Abdomen
2. (英) Adult
3. (英) Blood Gas Analysis
4. (英) Echocardiography, Transesophageal
5. (英) Female
6. (英) High-Frequency Jet Ventilation
7. (英) Humans
8. (英) Intermittent Positive-Pressure Ventilation
9. (英) Male
10. (英) Middle Aged
11. (英) Prospective Studies
12. (英) Pulmonary Artery
13. (英) Pulmonary Circulation
14. (英) Pulmonary Veins

1. (英) Article.PublicationTypeList.PublicationType: Clinical Trial

2. (英) Article.PublicationTypeList.PublicationType: Comparative Study

3. (英) Article.PublicationTypeList.PublicationType: Journal Article