Snapper J R, Brigham K L
Hosp Pract (Off Ed). 1986 May 15;21(5):87-91, 94-8, 101.
The pathophysiology of pulmonary edema formation has been discussed under normal conditions and when pulmonary capillary endothelial (and possibly alveolar epithelial) permeability are increased. The potential anatomic sites for pulmonary edema formation and the clinical relevance of the various sites were discussed. The role of potential "safety factors"--including increased lung lymph flow, increased interstitial hydrostatic pressure, and decreased interstitial protein osmotic pressure--in cardiogenic and fluid overload versus increased permeability pulmonary edema, were addressed. The clinical usefulness of quantitating various variables including pulmonary vascular pressures and lung water were also briefly discussed. Pulmonary edema fluid contains potential mediators that may contribute to the severity and chronicity of the lung injury. It is hoped that the concepts explored here should eventually provide clinically relevant information to guide in the management of critically ill patients with pulmonary edema.
已经在正常条件下以及肺毛细血管内皮（可能还有肺泡上皮）通透性增加时讨论了肺水肿形成的病理生理学。讨论了肺水肿形成的潜在解剖部位以及各个部位的临床相关性。探讨了潜在“安全因素”的作用，包括肺淋巴流量增加、间质静水压升高和间质蛋白渗透压降低，在心源性和液体超负荷与通透性增加性肺水肿中的作用。还简要讨论了量化包括肺血管压力和肺水在内的各种变量的临床实用性。肺水肿液含有可能导致肺损伤严重程度和慢性化的潜在介质。希望这里探讨的概念最终能提供临床相关信息，以指导对重症肺水肿患者的管理。
