Arterial Oxygen and Carbon-Dioxide Tension in Patients with Acute Myocardial Infarction

Abstract

Over a 2-year period, 450 cases of acute myocardial infarction were treated in a coronary care unit. Arterial PO₂ and PCO₂, were routinely determined on the day of admission. In this retrospective study, the patients were divided into groups according to their PaO₂ and PaCO₂ and the incidence of various clinical findings. Patients with low PaCO₂ and patients with low PaCO₂ values displayed the highest CCU and hospital mortality. Hypotension-shock and frank pulmonary edema were frequent in these patients. Pulmonary edema also was associated with high PaCO₂ values, but left heart failure without pulmonary edema was only correlated to low PaO₂ values. Supraventricular tachycardia, atrial flutter and fibrillation and left bundle branch block (including hemiblock) were common among patients with low PaO₂ and PaCO₂ values. Ventricular fibrillation was correlated to low PaO₂and high PaCO₂ values. The maximum respiratory rate recorded during the first day after admission proved an important indicator of short-term prognosis.

Acid‐base Disturbances in Patients With Acute Myocardial Infarction

“…In the present study SVT was more common in patients with low BE and SB values than in those with normal and high values, but had no relation to pH. In our group of AM1 patients SVT has been shown to be more common in patients with low PaCO, values (5). Thus it seems likely that in many patients with SVT the acidosis is compensated by hyperventilation, which explains the lack of relation between SVT and pH.…”

“…In the present study it is also evident that the acidosis of patients with frank pulmonary oedema need not only be of metabolic but also of respiratory origin. Six of our patients with frank pulmonary oedema had PaCO, values exceeding 45 mmHg and none of them had a history of obstructive pulmonary disease (5).…”

“…A F was more common in patients with low SB values but had no relation to pH. Many patients with A F also had low PaCO, values (5) and this probably explains the lack of relation between these arrhythmias and pH.…”

Der pulmonale Gaswechsel in der sp�ten Rehabilitationsphase des Myokardinfarktes

“…Funktionsst6rungen des pulmonalen Gaswechsels im Vertauf eines akuten Myokardinfarktes werden dutch die Rfickwirkungen eines linksventriculriren Versagens auf die Hfimodynamik des kleinen Kreislaufs verursacht und sind durch zahtreiche Untersuchungen belegt [5,7,12]. Obwohl in der Rehabilitationsphase die anffingliche arterielle Hypoxie oft nicht mehr nachzuweisen ist, zeigten doch Verlaufsbeobachtungen, dab in den ersten Monaten nach dem Infarktereignis Anderungen der Lungenfnnktion bestehen bleiben oder wieder auftreten, so dab bei der engen funktionellen Kopplung beider Organe aus MeBwerten des pulmonalen Gaswechsels eine Aussage fiber die kardiale Funktion m6glich erschien [18,19].…”