肺血管外水是严重烧伤儿童多器官衰竭发展的一个预测指标。

Anesteziologiia i reanimatologiia Pub Date : 2017-01-01
A U Lekmanov, D K Azovskiy, S F Pilyutik, V M Abramova
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引用次数: 0

摘要

目的:确定是否增加血管外肺水位(EVLW)将是多器官功能衰竭的一个预测因素,儿童严重烧伤患者。材料和方法:一项前瞻性研究纳入了33例PICU收治的烧伤表面占体表面积30%至90%的儿科患者。所有患者均采用picco技术进行高级血流动力学监测,包括PICU入院后48小时内每6小时evlw水平分析。结果:多脏器功能衰竭诊断依据DENVERII评分。1岁以下儿童体重指数ELWI(血管外肺水指数)正常值为9 ~ 29 ml/kg, 1 ~ 5岁儿童为7 ~ 25 ml/kg, 5岁以上儿童为5 ~ 13 ml/kg。结论:高度指数ELWI正常值为315 ml/m。在所有时间测量中,身高指数ELWI水平与多器官功能障碍综合征发生率可靠相关。因此,ELWI可作为MOD的预后因素。烧伤皮肤表面与EVLW水平无相关性。
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EXTRAVASCULAR LUNG WATER IS A PREDICTOR OF DEVELOPMENT OF MULTIPLE ORGAN FAILURE IN CHILDREN WITH SEVERE BURN INJURY.

The aim: to determine if an increased extravascular lung water level (EVLW) would be a predictor of multiple organ failure in pediatric patients with severe burn injury.

Materials and methods: a prospective study included 33 pediatric patients with burn surface from 30 to 90% of the total body surface area, admitted to PICU. All the patients were monitored with PICCO-technology advanced hemodynamic monitoring, that included an analysis ofEVLW level every 6 hours during first 48 hours after PICU admission.

Results: the diagnosis of multiple organ failure received according to DENVERII score. Normal values of weight indexed ELWI (extravascular lung water index)were 9-29 ml/kg for children under 1-year-oldage, 7-25 ml/kg for children from 1 to 5 years old and 5-13 ml/kg for children older than 5 years.

Conclusions: a normal value of height indexed ELWI was up to 315 ml/m. The height indexed ELWI level correlated reliably with multiple organ dysfunction syndrome rate in all time measurements. So ELWI can be used as a MOD prognostic factor There was no correlation between surface of burned skin and EVLW level.

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