Laggner A N, Lenz K, Grimm G, Sommer G, Gössinger H
Schweiz Med Wochenschr. 1987 Mar 21;117(12):445-9.
Hemofiltration has been advocated for reduction of extravascular lung water (EVLW) in both clinical and experimental ARDS. The influence of hemofiltration on EVLW was studied retrospectively in 10 patients with this syndrome. After 2 to 38 hours' hemofiltration net fluid balance was -3640 +/- 3609 ml. EVLW remained almost unchanged (from 17.6 +/- 5.4 before to 15.6 +/- 4.1 ml/kg after hemofiltration). In 4 patients a reduction of over 15% in EVLW was achieved, whereas in the remaining 6 patients EVLW changed within a range of +/- 10%. However, hemofiltration caused a decrease in cardiac output and oxygen delivery, thereby adversely affecting its benefits on EVLW and gas exchange. In ARDS hemofiltration should be performed under careful hemodynamic monitoring and only in some of the patients an immediate reduction in EVLW can be achieved.
在临床和实验性急性呼吸窘迫综合征（ARDS）中，血液滤过已被提倡用于减少血管外肺水（EVLW）。我们对10例该综合征患者进行回顾性研究，以探讨血液滤过对EVLW的影响。经过2至38小时的血液滤过，净液体平衡为-3640±3609毫升。EVLW几乎保持不变（从血液滤过前的17.6±5.4降至滤过后的15.6±4.1毫升/千克）。4例患者的EVLW降低超过15%，而其余6例患者的EVLW变化在±10%范围内。然而，血液滤过导致心输出量和氧输送减少，从而对其在EVLW和气体交换方面的益处产生不利影响。在ARDS中，应在仔细的血流动力学监测下进行血液滤过，并且只有部分患者能够立即实现EVLW的降低。
