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May 1, 1950Journal of Clinical Investigation237 citationsOpen Access

Studies of the Pulmonary Circulation in Man at Rest. Normal Variations and the Interrelations Between Increased Pulmonary Blood Flow, Elevated Pulmonary Arterial Pressure, and High Pulmonary “Capillary” Pressures 1

LDL DexterJDJames DowFHFlorence W. Haynes

Structured PICO

How do increased pulmonary blood flow, elevated pulmonary arterial pressure, and high pulmonary capillary pressure affect pulmonary arteriolar resistance and pressure gradients in humans at rest?

P
Population
42 human subjects studied at rest, including 8 normal patients (some with treated syphilis), 9 with left-to-right shunts (7 atrial septal defect, 2 patent ductus arteriosus), 3 with Eisenmenger's complex, 11 with mitral stenosis, and 11 with left ventricular failure.
I
Intervention
Right heart catheterization to measure pulmonary artery pressure, pulmonary 'capillary' (wedge) pressure, cardiac output, and calculate pulmonary arteriolar resistance.
C
Comparator
Comparisons made between normal subjects and those with increased pulmonary blood flow (shunts), elevated pulmonary arterial pressure (Eisenmenger's), or high pulmonary capillary pressure (mitral stenosis/LV failure).
O
Outcome
Pulmonary hemodynamics including pulmonary artery pressure, pulmonary capillary pressure, pressure gradient, and pulmonary arteriolar resistance.surrogate

This foundational physiological study demonstrates that pulmonary arteriolar resistance increases significantly when pulmonary capillary pressure exceeds 20-25 mm Hg, acting as a protective mechanism against pulmonary edema.

Limitations

  • Gross error in the calculation of blood flow by the direct Fick principle in congenital heart disease with shunts due to narrow arteriovenous oxygen differences.
  • Arbitrary zero point used for pressure recordings in relation to the actual tip of the catheter.
  • Inaccuracy of ventricular pressure curves due to artefacts produced by the catheter.

Abstract

While many studies have been carried out on the dynamics of the pulmonary circulation in ex- perimental animals, few studies of this subject have been made in man until recently. With the advent of the cardiac catheter (

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Cite This Study

Dexter et al. (1950) studied this question.

synapsesocial.com/papers/6a2130bbf69db56553c3c5bdhttps://doi.org/10.1172/jci102297
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