The effect of pulmonary thromboendarterectomy (PTE) on dead space ventilation in patients with chronic thrombo embolic pulmonary hypertension (CTEPH)
N. E. Verhey, H. J. Reesink, J. J. Kloek, P. Bresser, C. M. Roos (Amsterdam, The Netherlands)
Source: Annual Congress 2004 - Lung function technology: beyond the basic test
Session: Lung function technology: beyond the basic test
Session type: Thematic Poster Session
Number: 2498
Disease area: Pulmonary vascular diseases
Abstract Aim To assess the increase of dead space ventilation in patients with CTEPH and the effect of PTE.Methods 13 patients (10 F / 3 M, mean age 53,9 yrs) were studied before and 12-19 months after PTE. Capnography was performed at rest and physiological dead space was calculated using Bohr’s equation. Spirometry and SB-CO-transfer were measured following ERS standard.Results Preoperative VD/VT is increased. After PTE VD/VT decreased significantly and normalises in 8 patients. The alveolar part of the capnogram has a horizontal course comparable to normal subjects but with a lower PET,CO2 . This confirms the parallel origin of increased dead space. PET,CO2 and the Pa-ET,CO2 difference improve significantly after PTE. There is no significant change in spirometry, diffusion and ventilation that could explain the changes in dead space and capnography
pre-PTE post-PTE paired t-test mean ± std mean ± std p PET,CO2 kPa 3,4 ± 0,58 4,2 ± 0,56 <0,002 Pa-ET,CO2 kPa 1,20 ± 0,61 0,66 ± 0,56 <0,02 VD/VT physiol. 0,39 ± 0,07 0,31 ± 0,09 <0,001 alveolar slope %CO2/l 1,04 ± 0,53 0,97 ± 0,36 ns
Conclusions Measurement and follow up of VD/VT and capnography in patients with CTEPH is informative on the existence and severity of (parallel) dead space ventilation. Increased Pa-ET,CO2 with a horizontal alveolar plateau in the expiratory CO2 curve at rest is suspect for CTEPH.
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N. E. Verhey, H. J. Reesink, J. J. Kloek, P. Bresser, C. M. Roos (Amsterdam, The Netherlands). The effect of pulmonary thromboendarterectomy (PTE) on dead space ventilation in patients with chronic thrombo embolic pulmonary hypertension (CTEPH). Eur Respir J 2004; 24: Suppl. 48, 2498
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