Kirov M Iu, Kuz'kov V V, Bjertnaes L J, Nedashkovskiĭ E V
Anesteziol Reanimatol. 2003 Jul-Aug(4):41-5.
The key objective of the case study was the possibility to monitor the extravascular lung water (EVLW) in severe cases. Twelve mechanically ventilated patients with severe sepsis complicated by septic shock and by an acute lung injury (ALI) were involved in the prospective study. The measurements, performed on days 1 and 3 after the onset of sepsis, comprised hemodynamics, EVLW as assessed by Pulsion PiCCO method, blood gases and severity scores. The EVLW correlated significantly with lung injury score (r = 0.46), oxygenation (r = -0.46) and with pulmonary compliance (r = -0.58) versus the central venous pressure. The EVLW and lung injury scores were found to be essentially higher in non-survivors on day 3. The clinical situations, described in the present article, are indicative of a potential EVLW value applicable to sepsis treatment. Finally, the monitoring of EVLW is a useful tool in the purpose-oriented therapy of sepsis-induced ALI; moreover, the method has an important prognostic value.
该案例研究的关键目标是监测重症病例中的血管外肺水（EVLW）。12名机械通气的严重脓毒症患者，并发感染性休克和急性肺损伤（ALI），参与了这项前瞻性研究。在脓毒症发作后的第1天和第3天进行的测量包括血流动力学、通过Pulsion PiCCO方法评估的EVLW、血气和严重程度评分。与中心静脉压相比，EVLW与肺损伤评分（r = 0.46）、氧合（r = -0.46）以及肺顺应性（r = -0.58）显著相关。在第3天，非存活者的EVLW和肺损伤评分明显更高。本文所述的临床情况表明EVLW在脓毒症治疗中具有潜在价值。最后，监测EVLW是脓毒症诱导的ALI目标导向治疗中的有用工具；此外，该方法具有重要的预后价值。
