인공심폐기분리시 우심실과 좌심실충만압의 상호작용에 관한 연구

Abstract

The period of terminating cardiopulmonary bypass is one of the high-risk periods because it possesses a great deal of hemodynamic changes, This transition must be carefully controlled because a poorly performed transition can injure the patient. We inserted balloon-tipped thermo-dilution catheter in 12 patients who underwent valve replacement for evaluation of the hemodynamic changes and defining the reliable hemodynamic criteria of cardiopulmonary bypass weaning with the aid of cardiac output computer. In 7 patients, cardiopulmonary bypass weaning was uneventful at first attempt. The mean cardiac index was 2.73±0.32/min/m²and the mean CVP/PCWP ratio was 0.59±0.15. In 5 patients, at the first attempt of cardiopulmonary bypass weaning, the mean cardiac index was 1.74±0.20/min/m²and the amen CVP/PCWP ratio was 1.33±0.36. So cardiopulmonary bypass was resumed and the abnormal hemodynamic finding were corrected, then the cardiac index was resumed and the abnormal hemodynamic findings were corrected, then the cardiac index was 2.62±0.36/min/M²CVP/PCWP ratio was 0.83±0.05. These data suggest that the relationship between right and left ventricular filling pressures, the CVP/PCWP ratio, may be a more valuable guide during cardiopulmonary bypass weaning than the individual right and left ventricular filling pressures.