A patient is admitted to the critical care unit with an acute exacerbation of chronic emphysema. Respirations are 28 breaths/min. A pulmonary artery catheter is in place
Pulmonary artery systolic (PAS) is 38 mm Hg with a pulmonary artery mean (PAM) of 22 mm Hg. Blood gases reveal an uncompensated respiratory acidosis. Based on the readings obtained from the pulmonary artery catheter, the patient shows evidence of which of the following? a. Physiologic shunting c. Pulmonary hypertension
b. Widespread atelectasis d. Ventilation/perfusion mismatch
C
Pulmonary hypertension is defined as increased pressure (PAS greater than 35 mm Hg and PAM greater than 25 mm Hg at rest or greater than 30 mm Hg with exertion) within the pulmonary arterial system. It occurs when the cross-sectional area of the pulmonary bed decreases as a result of vasoconstriction or structural changes in the vascular bed.
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