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发布于:2018-12-5 15:32:01  访问:25 次 回复:0 篇
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S and septic shock <a href="https://www.ncbi.nlm.nih.gov/pubmed/26100631" title=View Abstract(s)">PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/26100631</a> under actual ICU
18, D-07740, Germany Crit Care 1999, 3 (suppl 1):P135 EMD-1214063 In Vivo Introduction: The transpulmonary double-indicator dilution technique enables to measure the intrathoracic blood volume (ITBV) and extravascular lung water (EVLW). Results: By using the equation mentioned above, thermodilution ITBV (ITBV*) and correlated ITBV*=(1.06 TBV)?24.3 [ml], r = 0.98, P < 0.0001. For thermodilution EVLW (EVLW*) linear regression analysis showed EVLW*=(0.83 VLW)+133.9 [ml] (r = 0.96, P < 0.0001).Conclusion: At least for patients on a surgical intensive care unit, single transpulmonary thermodilution is sufficiently accurate for the estimation of intrathoracic blood volume and extravascular lung water.P136 Diagnostic determinants for capillary leakage syndrome (CLS) in septic shock patientsG Marx, C Burczyk, M Cobas Meyer, B Vangerow, N Maassen*, KF Gratz, M Leuwer and H Rueckoldt Department of Anaesthesiology, *Physiology, and Nuclear Medicine, Hannover Medical School, D-30625 Hannover, Germany. Fax: +44-511-532-3642; E-mail:marx.gernot@mh-hannover.de Crit Care 1999, 3 (suppl 1):P136 Objectives: CLS is a frequent complication in sepsis characterized by loss of intravasal fluids leading to generalized edema and hypotension.S and septic shock under actual ICU conditions of frequent changes in ventilation, volume loading and catecholamine treatment. Methods : We analysed 581 hemodynamic profiles in 57 septic patients (60 ?15 years, SAPS II 53 ?15, SOFA 15 ?3) who received a 7.5 F pulmonary artery catheter and a 4 F flexible aortic catheter. Hemodynamic profiles were at least 15 min apart, the maximum time period was 24 h (8.25 ?5.30 h). Results : In all second profiles, changes in stroke index were accompanied by changes in ITBVI (r = 0.67) and not PCWP20 0 -20 -40 0SI [ml/m20 0 -20 -40 0--ITBVI [ml/mPCWP [mmHg](r = 0.07). Increases in SI (n = 265) were more often associated with increases in ITBVI (n = 189, 71.3 ) than in PCWP (n = 122, 46.0 ). Decreases in SI (n = 256) were associated with decreases in ITBVI in 176 (68.8 ) and for PCWP in 119 cases (46.5 ). Conclusion : In the early phase of hemodynamic stabilisation of patients with sepsis or septic shock, ITBVI is a more reliable indicator of cardiac preload than the PCWP.P135 Assessment of intrathoracic blood volume and extravascular lung water by single transpulmonary thermodilutionSG Sakka, A Meier-Hellmann and K Reinhart Department of Anesthesiology and Intensive Care Medicine, Friedrich-Schiller University of Jena, Bachstr. 18, D-07740, Germany Crit Care 1999, 3 (suppl 1):P135 Introduction: The transpulmonary double-indicator dilution technique enables to measure the intrathoracic blood volume (ITBV) and extravascular lung water (EVLW). Since this technique is relatively time consuming and expensive, we studied whether the global end-diastolic volume (GEDV) which can be derived only from single indicator dilution (thermodilution) allows the estimation of intrathoracic blood volume. Methods: In a heterogeneous population of 57 critically ill patients (56 ?15 years) we found by structural regression analysis a correlation of ITBV=(1.25 EDV)?8.4 [ml]. We then applied this equation on the first double-indicator measurements in 209 other patients (52 ?19 years) with sepsis (n = 98), ARDS (n = 31), head injury (n = 38), hemorrhagic shock (n = 19), intracranial hemorrhage (n = 19), brain infarction (n = 3), and heart failure (n = 1).
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