Abstract
Recent advances in pulmonary care have involved improvement in the distribution of ventilation, but improvement in the distribution of pulmonary perfusion in a clinical setting has not been described. In this report, 2 pediatric patients are described with severe aspiration pneumonitis and hypoxia for whom conventional therapy with mechanical ventilation and high PEEP was of limited benefit. A 4-lumen pulmonary artery catheter was placed into the pulmonary artery supplying the lobe most diseased by chest radiograph. Pulmonary blood flow distribution was changed by total and partial inflation and deflation of the pulmonary artery balloon. This resulted in a marked alteration in shunt fraction and allowed significant reduction in F1O2. The pathophysiological and therapeutic implications of manipulating pulmonary artery blood flow distribution with a pulmonary artery catheter are discussed.
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