[Incidence and prognostic significance of pulmonary artery thromboses in patients with acute respiratory failure: a study of 106 patients using bilateral pulmonary balloon occlusion angiography].

In 106 patients suffering from acute respiratory failure of different severity 157 bedside balloon occlusion pulmonary angiographic studies have been performed through a pulmonary artery catheter to assess the frequency and extent of intravascular occlusive disease. The vascular alterations in acute respiratory failure impair the prognosis essentially. The decreasing pulmonary vascular cross-section causes a greater pulmonary vascular resistance and consecutive pulmonary artery hypertension and finally right heart failure. In 33% of patients multiple thrombosis and in 15.1% singularly pulmonary artery filling defects could be shown. In 21.7% a decreased background opacification caused by extensive microthrombosis was present. Only in 30.2% the angiography was interpreted as normal. The mortality rate was significant higher in patients with multiple macro- and microthrombosis (82.9% respectively 52.2%) compared to patients with singular pulmonary artery filling defects and normal angiography (37.5% respectively 28.1%). The angiographic result was further correlated with the severity of the acute respiratory failure, the haemodynamic and haemostasiologic data, the degree of consolidation in the chest-X-ray and the post mortem angiographic studies.