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Báo cáo y học: "Assessing the quantity of pulmonary edema in critically ill children"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Assessing the quantity of pulmonary edema in critically ill children. | McAuley et al. Critical Care 2010 14 189 http ccforum.eom content 14 4 189 CRITICAL CARE COMMENTARY L__ Assessing the quantity of pulmonary edema in critically ill children Daniel F McAuley1 2 Lisa M Brown3 4 and Michael A Matthay4 5 See related research by Lemson etal. http ccforum.eom content 14 3 R105 Abstract Measuring extravascular lung water may be useful for predicting outcome in adults with acute lung injury. The present commentary briefly reviews the potential role and limitations of extravascular lung water measurement in critically ill children. In the previous issue of Critical Care Lemson and colleagues used the single-indicator transpulmonary thermo dilution method to determine the correlation between extravascular lung water EVLW measurement and the degree of pulmonary edema on the chest radiograph in 27 critically ill children 10 years old 1 . All of the children required invasive hemodynamic monitoring and mechanical ventilation. The authors report that EVLW did not correlate with the chest radiograph score of pulmonary edema or oxygenation. The authors also report however that EVLW is an age-dependent variable. This is an important initial step in the investigation of EVLW measurements in critically ill children. The accumulation of fluid in the interstitium and alveolar space can be measured by quantifying EVLW. This can be measured using the single-indicator trans-pulmonary thermodilution method. This method has been validated against both the gold standard gravimetric method in animal models 2 and the technically more difficult and more time consuming in vivo doubleindicator technique in which EVLW is directly measured via injection of a freely diffusible cold indicator and a plasma-bound indicator 3 4 . The principles underlying thermodilution have been reviewed recently 5 6 . Using the transpulmonary thermodilution method EVLW can be measured in adults at the bedside. Early Correspondence d.f.mcauley@qub.ac.uk Regional Intensive Care