糖皮质激素对急性呼吸窘迫综合征血管外肺水的影响

doi:10.3969/j.issn.1002-1949.2016.05.0014

Chinese Journal of Critical Care Medicine

2016, Vol. 36

Issue (5): 443-447 DOI: 10.3969/j.issn.1002-1949.2016.05.0014

Effect of glucocorticoid on extravascular lung water in the patients with acute respiratory distress syndrome

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Abstract Objective To evaluate the effect of glucocorticoids on extravascular lung water index（EVLWI）, pulmonary vascular permeability index（PVPI）, oxygenation index, APACHE Ⅱ score and prognosis in the patients with acute respiratory distress syndrome（ARDS）. Methods A total of 40 ventilated patients with ARDS selected from ICU were randomly divided into study group and control group,with 20 cases in each group. The study group accepted glucocorticoid therapy but the controls do not. EV⁃LWI and PVPI were observed by pulse indicator continuous cardiac output（PICCO）, partial pressure of oxygen and oxygenation index were measured by blood gas analysis. All of the indexes were measured before and on 24 h, 48 h and 72 h after treatment. Duration of ventilation, hospitalized days in ICU，and APACHE Ⅱ score were compared between the two groups. Results EVLWI, PVPI, oxygenation index and APACHE Ⅱ score had no statistical difference in the two groups before treatment（P＞0.05）. EVL⁃ WI, PVPI, APACHE Ⅱ levels were lower and oxygenation index were higher after treatment. EVLWI,PVPI on 24 h, 48 h, 72 h and APACHE Ⅱ score on 48 h, 72 h after treatment in study group decreased significantly compared with those in control group（P＜0.05）. Oxygenation index on 48 h, 72 h after treatment in study group increased significantly compared with those in control group（P＜0.05）. The duration of ventilation and hospitalized days in ICU were obviously shorter in study group compared with control group（P＜0.05）. Conclusion Glucocorticoid could decrease the EVLWI and PVPI levels, improve the oxygenation index in ARDS patients, also decrease the duration of ventilation and hospitalized days in ICU.

Received: 19 November 2015

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2016.05.0014 OR http://www.cnemergency.org.cn/EN/Y2016/V36/I5/443

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