血管外肺水在危重患者中的预测价值被引量：7

The Prognostic Value of Extravascular Lung Water in Critical Ill Patient

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摘要在危重患者的监测中,心肺功能的监测是最重要的。在许多危重患者的治疗过程中,治疗的首要目的是改善和维持器官的灌注,为了达到这个目的,就需要保证有一定的前负荷,这样就有肺水肿的危险,而肺水肿是危重患者的呼吸衰竭的原因。如何在既保证器官灌注基础上又不引起肺水肿一直是危重患者治疗上的一个难题,同时在早期预测危重患者预后上缺乏指标。近年来血管外肺水(EVLW)作为评价心肺功能的指标以及早期评价预后上的价值在临床上越来越得到广泛应用。 Cardiac and pulmonary monitoring is very important in critical ill patient, the first aim is to improve and sustain the perfusion of main organs. To obtain this subject, enough preload must be ensured, however, this will increase tile incidence of pulmonary edema which is the common reason of respiratory failure. It is always an intractable problem in the therapy of critical care to sustain the parfusion of main organ while not induce pulmonary edema, meantime, meanwhile, there is a lack of sensitive index to forecast the prognosis of critical ill patients. In recent years ,extravaseular lung water as an index to estimate the function of heart and pulmonary has been widely applied m clinic,and shown its important value in annraise prognosis.

作者张伟

机构地区天津市第三中心医院ICU

出处《医学综述》 2006年第3期177-179,共3页 Medical Recapitulate

关键词血管外肺水肺水肿脓毒症危重病 Extravascular lung water Pulmonary edema Sepsis Critical care

分类号 R631.4 [医药卫生—外科学] R563.8 [医药卫生—呼吸系统]

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1Kiashiro S, Sugiura T, Tamura T, et al. Factors assaclatcd with increased extravaacular lung water in cardiac tamponade and myocardial ischemia[ J]. Crit Care Med, 1999,27(10) : 2229-2233.
2Lewis FR, Elings VB, Hil SL, et al. The measurement of extravascular lung water by thermal-green dye indicator dilution[J]. Ann N Y Acad Sci, 1982,384: 394-410.
3Pfeiffer UJ,Backua G,Blomel G, et al.A fiberopties-bazed system for integrated monitoring of cardiac output, intrathoracic blood volume,extravaaeular lung water, O2 saturation, and a-v differences. In : Lewis FR Pfeiffer U J, eds. Practical applications of fibempties in critical care monitoring[M]. Berlin, Germany: Springer-Verlag, 1990.114-125.
4Neumann P. Extravascular lung water and intrathoracic blood volum:double vs single indicator dilution tcchnique[J]. Intenive Care Med,1999,2.5(2) :216-219.
5Sakka SG, Ruhl CC, Pfeiffer U J, et al. Assessment of cardiac preload and extravascular lung water by single transpulmonary thermodilution[J]. Intensive Care Meal, 2000.26(2) : 180-187.
6Hudson E, Beale R. Lung water and blood volume measurement in the critically ill[J]. Curt Opin Crit Care,2000,6(2):222-226.
7Goedje O, Hoeke K, Thile M, et al. First experiences with a new pulse-contour-based device for less invasive, continuous cardiac-output monitoring[ J] .Crit Care Mcd, 1999,27(1 Suppl 279) :A119.
8Goedje O, Hoeke K, Lictwarck-Aschoff M, et al. Continuous cardiac output by femoral arterial thermodilution calibrated pulse contour analysis: comparison with pulmonary arterial thermodilution[ J ]. Crit Care Med 1999,27 ( 11 ) : 2407-2412.
9Ware LB, Matthay MA. The acute respiratory distress syndrome[J]. N Eng J Med,2000,342(5) : 1334-1349.
10Staub NC, Hyde RW, Crandall E. NHLBI workshop summary : workshop on technique to evaluate lung alveolar-microvascular injury[J]. Am Rev Respir Dis, 1990,141(4 Pt 1 ) : 1071-1077.