Fernández-Mondéjar Enrique, Guerrero-López Francisco, Colmenero Manuel
Intensive Care Unit, Virgen de las Nieves University Hospital, Granada, Spain.
Curr Opin Crit Care. 2007 Feb;13(1):79-83. doi: 10.1097/MCC.0b013e328011459b.
Accurate quantification of extravascular lung water is an important issue in the management of patients with pulmonary edema. The single transpulmonary thermal indicator method has been available since the late 1990s. Its simplicity and easy application make it clinically attractive.
Several experimental studies have confirmed the accuracy of the single transpulmonary thermal indicator technique in comparisons with postmortem gravimetric method. Whereas changes in extravascular lung water of less than 100-200% are undetectable by other clinically applicable methods of lung injury assessment (chest radiograph and oxygenation), the single transpulmonary indicator has proven highly sensitive to small (10-20%) increases and is therefore useful to detect incipient pulmonary edema. In patients with sepsis or acute respiratory distress syndrome, extravascular lung water measurement offers information unobtainable by other means.
Extravascular lung water can be considered a relevant parameter that contributes to rational management of fluid and vasoactive therapy of many critically ill patients and offers a fuller picture of their overall lung function.
准确量化血管外肺水是肺水肿患者管理中的一个重要问题。单肺热指示剂法自20世纪90年代末就已存在。其简单性和易于应用使其在临床上具有吸引力。
多项实验研究已证实，与尸体重量法相比，单肺热指示剂技术具有准确性。虽然其他临床适用的肺损伤评估方法（胸部X线片和氧合）无法检测到血管外肺水小于100 - 200%的变化，但单肺热指示剂已被证明对小幅度（10 - 20%）的增加高度敏感，因此有助于检测早期肺水肿。在脓毒症或急性呼吸窘迫综合征患者中，血管外肺水测量提供了其他方法无法获得的信息。
血管外肺水可被视为一个相关参数，有助于对许多危重症患者进行合理的液体和血管活性药物治疗管理，并更全面地反映其整体肺功能。
