Nierman D M, Eisen D I, Fein E D, Hannon E, Mechanick J I, Benjamin E
Department of Medicine, The Mount Sinai Medical Center, New York, New York 10029-6574, USA.
J Surg Res. 1996 Oct;65(2):101-8. doi: 10.1006/jsre.1996.0350.
We used a porcine endotoxemic model of acute lung injury to compare extravascular lung water (EVLW) measured by right transthoracic bioimpedance to postmortem gravimetric EVLW measurements. Adult pigs were randomized into control (N = 5) or endotoxin groups [150 microgram/kg Escherichia coli lipopolysaccharide B for 1 hr followed by 3 hr of resuscitation for a thermodilution cardiac output less than 90% of baseline using either isotonic saline (N = 5) or isooncotic albumin (N = 5)]. Right lung resistance was measured using a novel electrode array and a highly sensitive analyzer and was used to calculate right lung resistivity. At the end of the experiment, animals in the endotoxin-albumin group had higher gravimetric EVLWs than those in the endotoxin-saline or control groups (P < 0.05). Right lung resistivity corrected for body weight significantly correlated with gravimetric EVLW (r2 = 0.49; SEE = 0.96; P = 0.0038). Using multiple regression analysis, a predictive equation for EVLW based on right lung resistivity, body weight, and mean pulmonary artery pressure was generated (r2 = 0.81; SEE = 0.60; P < 0.0001). These results demonstrate that right lung resistivity measurements can provide a noninvasive estimate of EVLW. In addition, crystalloid may be preferable to colloid for fluid resuscitation in noncardiogenic pulmonary edema.
我们使用猪急性肺损伤内毒素血症模型，比较经右胸生物阻抗测量的血管外肺水（EVLW）与死后重量法测量的EVLW。成年猪被随机分为对照组（N = 5）或内毒素组[150微克/千克大肠杆菌脂多糖B，持续1小时，随后进行3小时复苏，使用等渗盐水（N = 5）或等渗白蛋白（N = 5），以使热稀释心输出量低于基线的90%]。使用新型电极阵列和高灵敏度分析仪测量右肺电阻，并用于计算右肺电阻率。实验结束时，内毒素 - 白蛋白组动物的重量法EVLW高于内毒素 - 盐水组或对照组动物（P < 0.05）。校正体重后的右肺电阻率与重量法EVLW显著相关（r2 = 0.49；SEE = 0.96；P = 0.0038）。使用多元回归分析，生成了基于右肺电阻率、体重和平均肺动脉压的EVLW预测方程（r2 = 0.81；SEE = 0.60；P < 0.0001）。这些结果表明，右肺电阻率测量可以提供EVLW的无创估计。此外，在非心源性肺水肿的液体复苏中，晶体液可能比胶体液更可取。
