Khan Saheed, Trof Ronald J, Groeneveld A B Johan
Department of Intensive Care, VU University Medical Center, Amsterdam, The Netherlands.
Curr Opin Crit Care. 2007 Jun;13(3):303-7. doi: 10.1097/MCC.0b013e32811d6ccd.
This review highlights current insights concerning the (measurement of) extravascular lung water as an index of pulmonary edema, by transpulmonary dilution techniques. The focus is on the applicability of the technique at the bedside in monitoring critically ill patients.
Several (animal) studies have been performed to validate the technique by postmortem gravimetry in different conditions. Moreover, recent clinical data emphasize the utility of the thermodilution-derived extravascular lung water, its contribution to the clinical manifestations of acute lung injury/acute respiratory distress syndrome, its response to treatment aimed at edema prevention or resolution, and as a prognostic parameter.
The thermodilution-derived extravascular lung water is a useful adjunct to assess lung vascular injury, cardiogenic edema and overhydration and to guide treatment in critically ill patients. The effects on morbidity and mortality of this approach need to be studied further.
本综述重点介绍了通过经肺稀释技术将血管外肺水（测量）作为肺水肿指标的当前见解。重点在于该技术在床边监测重症患者的适用性。
已经进行了多项（动物）研究，通过在不同条件下的尸体重量测定来验证该技术。此外，最近的临床数据强调了热稀释法衍生的血管外肺水的效用、其对急性肺损伤/急性呼吸窘迫综合征临床表现的影响、其对旨在预防或消除水肿的治疗的反应以及作为一个预后参数。
热稀释法衍生的血管外肺水是评估肺血管损伤、心源性水肿和水合过多以及指导重症患者治疗的有用辅助手段。这种方法对发病率和死亡率的影响需要进一步研究。
