Rafferty T D, Ljungquist R, Firestone L, Curtis A, Raven C, Hui S, Barash P G
Arch Surg. 1983 Jul;118(7):841-3. doi: 10.1001/archsurg.1983.01390070049010.
Because Starling's equation contains four factors that theoretically influence fluid movement across the pulmonary capillary bed, we prospectively examined the relationship between the plasma colloid oncotic pressure (PCOP) minus the mean pulmonary artery occlusion pressure (PAOP) (the only two presently available clinically for measurement) and pulmonary edema determined in terms of percent venous admixture (Qs/Qt) and roentgenographically in 17 consecutive patients in a surgical intensive care unit to determine whether this PCOP-PAOP gradient could accurately predict the presence of pulmonary edema. The PCOP-PAOP gradient proved to be a poor predictor of pulmonary edema determined by these means. We believe this resulted from the inherent insensitivity of the PCOP-PAOP gradient as an estimate of the net intravascular filtration pressure, and Qs/Qt and roentgenograms as measurements of lung edema, as well as the multiplicity of variables involved in the genesis of pulmonary edema in the clinical situation.
由于斯塔林方程包含四个理论上影响液体通过肺毛细血管床流动的因素，我们前瞻性地研究了血浆胶体渗透压（PCOP）减去平均肺动脉闭塞压（PAOP）（目前临床上仅有的两个可测量值）与通过静脉血掺杂百分比（Qs/Qt）和X线检查确定的肺水肿之间的关系，研究对象为外科重症监护病房的17例连续患者，以确定该PCOP - PAOP梯度是否能准确预测肺水肿的存在。结果证明，通过这些方法测定，PCOP - PAOP梯度对肺水肿的预测效果不佳。我们认为，这是由于PCOP - PAOP梯度作为血管内净滤过压估计值的固有不敏感性、Qs/Qt和X线片作为肺水肿测量方法的固有不敏感性，以及临床情况下肺水肿发生过程中涉及的多种变量所致。
