Feiss P, Gay R
Ann Anesthesiol Fr. 1975;16 Spec No 2-3:191-5.
All hypervolemia or any decrease in plasma oncotic pressure leads to deterioration in lesional pulmonary edema. The aim of albumin infusions is to restore the plasma oncotic pressure and to oppose the passage of water into the extravascular space. This therapy is however debatable owing to the abnormal increase in the permeability of the alveolo-capillary membrane to proteins. Diuretics enable one to lower the volemia and to maintain the pulmonary capillary pressure at its minimum level. However, strict hemodynamic supervision is absolutely necessary. Cortico-steroids have been recommended without serious physiopathological justification. However, they have a preventive action on interstitial edema in endotoxic shock.
所有的血容量过多或血浆胶体渗透压的任何降低都会导致损伤性肺水肿的恶化。输注白蛋白的目的是恢复血浆胶体渗透压,并阻止水进入血管外间隙。然而,由于肺泡-毛细血管膜对蛋白质的通透性异常增加,这种治疗方法存在争议。利尿剂能降低血容量,并将肺毛细血管压力维持在最低水平。然而,严格的血流动力学监测是绝对必要的。皮质类固醇的使用虽缺乏严格的生理病理依据,但对感染性休克中的间质性水肿有预防作用。