Pulmonary capillary pressure in pulmonary hypertension.
BACKGROUND
Pulmonary capillary pressure (PCP), together with the time constants of the various vascular compartments, define the dynamics of the pulmonary vascular system. Our objective in the present study was to estimate PCPs and time constants of the vascular system in patients with idiopathic pulmonary arterial hypertension (IPAH), and compare them with these measures in patients with acute respiratory distress syndrome (ARDS).


METHODS
We conducted the study in two groups of patients with pulmonary hypertension: 12 patients with IPAH and 11 with ARDS. Four methods were used to estimate the PCP based on monoexponential and biexponential fitting of pulmonary artery pressure decay curves.


RESULTS
PCPs in the IPAH group were considerably greater than those in the ARDS group. The PCPs measured using the four methods also differed significantly, suggesting that each method measures the pressure at a different site in the pulmonary circulation. The time constant for the slow component of the biexponential fit in the IPAH group was significantly longer than that in the ARDS group.


CONCLUSIONS
The PCP in IPAH patients is greater than normal but methodological limitations related to the occlusion technique may limit interpretation of these data in isolation. Different disease processes may result in different times for arterial emptying, with resulting implications for the methods available for estimating PCP.
Souza
Rogerio
R
Pulmonary Division, Respiratory ICU - Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. rgrsz@uol.com.br
Amato
Marcelo Britto Passos
MB
Demarzo
Sergio Eduardo
SE
Deheinzelin
Daniel
D
Barbas
Carmen Silvia Valente
CS
Schettino
Guilherme Paula Pinto
GP
Carvalho
Carlos Roberto Ribeiro
CR
D000465:Algorithms; D021721:Balloon Occlusion; D001794:Blood Pressure; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology*; D007258:Informed Consent; D008991:Monitoring, Physiologic; D011651:Pulmonary Artery / Q000503:physiopathology; D011652:Pulmonary Circulation; D011669:Pulmonary Wedge Pressure / Q000502:physiology*; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000503:physiopathology*; D013997:Time Factors; D014655:Vascular Resistance