tetano
Editor, Senior Moderator
Wien Klin Wochenschr. 2010 Oct 20. [Epub ahead of print]
The relationship between extravascular lung water and oxygenation in three patients with influenza A (H1N1)-induced respiratory failure.
Hasibeder WR, D?nser MW, Halabi M, Brinninger G.
Department of Anesthesia and Critical Care Medicine, Hospital of the Barmherzigen Schwestern, Ried im Innkreis, Austria.
Abstract
This case series reports the correlation between extravascular lung water (EVLW) and the partial arterial oxygen pressure/fractional inspiratory oxygen (PaO(2)/FiO(2)) ratio in three patients with severe influenza A (H1N1)-induced respiratory failure. All patients suffered from grave hypoxia (PaO(2), 26-42 mmHg) and were mechanically ventilated using biphasic airway pressure (PEEP, 12-15 mmHg; FiO(2), 0.8-1) in combination with prone positioning at 12 hourly intervals. All patients were monitored using the PICCO(?) system for 8-11 days. During mechanical ventilation, a total of 62 simultaneous determinations of the PaO(2)/FiO(2) ratio and EVLW were performed. A significant correlation between EVLW and the PaO(2)/FiO(2) ratio (Spearman-rho correlation coefficient, -0.852; p < 0.001) was observed. In all patients, a decrease in EVLW was accompanied by an improvement in oxygenation. Serum lactate dehydrogenase levels were elevated in all patients and significantly correlated with EVLW during the intensive care unit stay (Spearman-rho correlation coefficient, 0.786; p < 0.001). In conclusion, EVLW seems increased in patients with severe H1N1-induced respiratory failure and appears to be closely correlated with impairments of oxygenatory function.
PMID: 20949325 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20949325
The relationship between extravascular lung water and oxygenation in three patients with influenza A (H1N1)-induced respiratory failure.
Hasibeder WR, D?nser MW, Halabi M, Brinninger G.
Department of Anesthesia and Critical Care Medicine, Hospital of the Barmherzigen Schwestern, Ried im Innkreis, Austria.
Abstract
This case series reports the correlation between extravascular lung water (EVLW) and the partial arterial oxygen pressure/fractional inspiratory oxygen (PaO(2)/FiO(2)) ratio in three patients with severe influenza A (H1N1)-induced respiratory failure. All patients suffered from grave hypoxia (PaO(2), 26-42 mmHg) and were mechanically ventilated using biphasic airway pressure (PEEP, 12-15 mmHg; FiO(2), 0.8-1) in combination with prone positioning at 12 hourly intervals. All patients were monitored using the PICCO(?) system for 8-11 days. During mechanical ventilation, a total of 62 simultaneous determinations of the PaO(2)/FiO(2) ratio and EVLW were performed. A significant correlation between EVLW and the PaO(2)/FiO(2) ratio (Spearman-rho correlation coefficient, -0.852; p < 0.001) was observed. In all patients, a decrease in EVLW was accompanied by an improvement in oxygenation. Serum lactate dehydrogenase levels were elevated in all patients and significantly correlated with EVLW during the intensive care unit stay (Spearman-rho correlation coefficient, 0.786; p < 0.001). In conclusion, EVLW seems increased in patients with severe H1N1-induced respiratory failure and appears to be closely correlated with impairments of oxygenatory function.
PMID: 20949325 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20949325