Coexistent Chronic Obstructive Pulmonary Disease Research Articles

Pulmonary Arteriovenous Fistula: Preoperative Evaluation with a Swan-Ganz Catheter

A balloon-tipped catheter was used in the preoperative assessment of a patient with a solitary pulmonary arteriovenous fistula and coexistent chronic obstructive pulmonary disease and ischemic heart disease. Studies before and two months following surgical excision of the fistula showed that the increase in arterial oxygenation (49 mm Hg vs 77 mm Hg) and the reduction in the fraction of the shunted cardiac output (37% vs 6%) closely approximated the predicted preoperative estimates.

Pulmonary function studies. Aid to diagnosis of pulmonary embolism.

Serial measurement of lung volumes, effort-dependent expiratory flow rates, and steady-state diffusing capacity helped to establish the diagnosis of acute pulmonary embolism in 31 patients with angiograms demonstrating vascular obstruction. Also, analysis of results separated patients with pulmonary embolism alone from patients with pulmonary embolism and associated, pulmonary infarction, or from patients with coexistent chronic obstructive pulmonary disease and left ventricular failure (the most common diseases to mimic the clinical picture of pulmonary embolism in these patients). Not only were these methods helpful in establishing the diagnosis of acute pulmonary embolism, but also in evaluating the rate of resolution of vascular obstruction and the deficit in pulmonary function following resolution.

Pulmonary Function Studies

Serial measurement of lung volumes, effort-dependent expiratory flow rates, and steady-state diffusing capacity helped to establish the diagnosis of acute pulmonary embolism in 31 patients with angiograms demonstrating vascular obstruction. Also, analysis of results separated patients with pulmonary embolism alone from patients with pulmonary embolism and associated, pulmonary infarction, or from patients with coexistent chronic obstructive pulmonary disease and left ventricular failure (the most common diseases to mimic the clinical picture of pulmonary embolism in these patients). Not only were these methods helpful in establishing the diagnosis of acute pulmonary embolism, but also in evaluating the rate of resolution of vascular obstruction and the deficit in pulmonary function following resolution.