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KMID : 0385919920030020023
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Journal of the Korean Society of Emergency Medicine
1992 Volume.3 No. 2 p.23 ~ p.30
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Intrapulmonary Shunt And Effect of Peep Therapy on Pulmonary Contusion
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황성오
김영식/안무업/임경수/오중환/윤정한/최경훈/강성준
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Abstract
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To evaluate the physiologic extent of pulmonary contusion arid effect of PEEP therapy for pulmonary contusion, we studied 16 patients received PEEP therapy with pulmonary contusion from nonpenetrating chest trauma. Hemodynamic parameters
including
pulmonary vascular resistance index and intrapulmonary shunt fraction were caiculated from standard measurement, and arterial oxygen tension was measured. Pulmonary vascular resistance index and intrapulmonary shunt fraction were increased in
patient
group. Arterial oxygen tension was decreased with increasd of the intrapulmonary shunt fraction (R=0.75). Arter minimal PEEP therapy (5-10 cmH2O). pulmonary vascular resistance index was remained unchanged and intrapulmonary shunt fraction was
decreased
without significant changes of pulmonary hemodynamics. Increment of arterial tension was increased with decrease of intrapulmonary shunt fraction (R=0.43). Decreased stroke volume index suggested of cardiac injury such as cardiac contusion in
patient
group. These results of our study suggested that increased intrapulmonary shunt fraction caused arterial hypoxia in pulmonary contusion and a terial oxygen tension was increasd as a result of reduced intrapulmonary shunt by PEEP therapy.
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