Shaffer S G, Glenski J A, Callenbach J C, Hall F K, Sheehan M B, Thibeault D W, Hall R T
Am J Perinatol. 1984 Apr;1(3):203-7. doi: 10.1055/s-2007-1000005.
Measurements of body water homeostasis and pulmonary function were obtained in 24 infants with respiratory distress syndrome requiring mechanical ventilation during the first five days of life to determine the relationship of diuresis to improvement in pulmonary function. Initial diuresis (output intake ratio greater than 0.8) occurred at 24 hours, maximum diuresis (output intake ratio greater than or equal to 1.6) at 40 hours, and initial improvement in pulmonary function (fall in AaDO2 greater than 50 mm Hg) at 48 hours. Urine flow rates over four-, eight-, or 12-hour periods were quite variable and correlated poorly with improvement in pulmonary function. Reduction in body weight was a more accurate indicator of total changes in body water than urine output, output intake ratio, or fractional excretion of sodium. Although there was a temporal relationship of loss of body water and improvement in pulmonary function by analysis of means, no cause-and-effect relationship could be found on a case-by-case analysis. Five of 24 infants demonstrated improvement in pulmonary function prior to diuresis or reduction in body weight. Nine infants had a diuresis more than 24 hours prior to pulmonary improvement, and two infants had a diuresis without pulmonary improvement during the five-day study period. These data indicate that factors other than body water are associated with improvement in pulmonary function in infants with respiratory distress syndrome.
对24例在出生后前五天需要机械通气的呼吸窘迫综合征婴儿进行了身体水分稳态和肺功能测量，以确定利尿与肺功能改善之间的关系。初始利尿（输出/输入比大于0.8）发生在24小时，最大利尿（输出/输入比大于或等于1.6）发生在40小时，肺功能初始改善（肺泡-动脉血氧分压差下降大于50mmHg）发生在48小时。4小时、8小时或12小时期间的尿流率变化很大，与肺功能改善的相关性很差。体重减轻比尿量、输出/输入比或钠排泄分数更能准确反映身体水分的总体变化。虽然通过均值分析发现身体水分丢失与肺功能改善之间存在时间关系，但在逐个病例分析中未发现因果关系。24例婴儿中有5例在利尿或体重减轻之前肺功能就已改善。9例婴儿在肺功能改善前24小时以上出现利尿，2例婴儿在为期五天的研究期间出现利尿但肺功能未改善。这些数据表明，除身体水分外，其他因素也与呼吸窘迫综合征婴儿的肺功能改善有关。
