[Balloon occlusion pulmonary angiography and anticoagulant-antithrombotic therapy in ARDS-associated pulmonary vascular thrombosis].
Balloon occlusion pulmonary angiography was used to assess the frequency of pulmonary vascular thrombosis in five patients suffering from ARDS of diverse causes. Pulmonary hypertension, elevated pulmonary vascular resistance and disseminated intravascular coagulation were observed in all patients. Pulmonary artery filling defects (PAFD) were found in four of five patients. The results suggest that PAFD can be detected in a large proportion of patients in ARDS. It was therefore speculated that the detection of PAFD is a sign of severe lung injury. Urokinase, heparin and protease inhibitor were infused to test the potential reversibility of pulmonary vascular thrombosis in four patients. After infusion, we found angiographic evidence of clearing of obstruction in arteries in three of four patients. We conclude that anticoagulant-antithrombotic therapy can improve hemodynamics in ARDS-associated pulmonary vascular thrombosis.
Miyazawa
T
T
Department of Internal Medicine, Hiroshima City Hospital, Japan.
Tanemori
N
N
Utsumi
T
T
Katayama
S
S
Furukawa
N
N
D000328:Adult; D000368:Aged; D016670:Gabexate; D006146:Guanidines / Q000627:therapeutic use*; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D012128:Respiratory Distress Syndrome / Q000150:complications* / Q000188:drug therapy; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D006146:Guanidines; D016670:Gabexate; D006493:Heparin; D014568:Urokinase-Type Plasminogen Activator