The relationship between the extravascular lung water and the prognosis of patients with septic shock

Abstract

Objective To analyze the variable characteristics of the extravascular lung water(EVLW)in the patients with septic shock,to chrify its value in the prognosis of these patients,and to find out a determinent in objective assessment of the capillary leakage syndrome.Method The investigation was carried out with prospective design and retrospective analysis.The patients with hyperkinetic septic shock confirmed by the monitor of the pulse-indicated continuous cardiac output(PICCO),admitted into the medical intensive care unit of the Nou-vel H(o)pital Civil of Louis·Pasteur University,were divided into survival group and fatal group.The hemodynamic status including EVLW was measured in 3 consecutive days.and the relationship between the EVLW and the prog-nosis of patients was analyzed.Results Totally 20 patients with average age of 69.1 years old(ranging from 48 to 84),13 male and 7 female,were 12 survivors and 8 deaths.On the first day of diagnosis,EVLW were higher in both groups in comparison with normal value.They were 19.9±8.0 mL/kg in survival patients and 18.7±8.1 mL/kg in fatal patients.However,on the second day,the EVLW in the survival patients dropped significantly af-ter intensive intervention,but the fatal patients did not responded well to the treatment and the EVLW declined slightly.The values of EVLW of both groups began to diverge significantly from each other,showing values in means of 13.8±4.5 and 18.6±6.3,respectively(P＜0.05).On the third day,this diffence between two groups was still more remarkable,resulting in 10.1±2.7 vs.16.6±6.3(P＜0.05).Conclusions The changes of EVLW could be used to evaluate the effectiveness of treatment and to predict the prognosis of the pa-tients with septic shock.EVLW would likely be an indicator to evaluale the pulmonary capillary leakage. Key words: Septic shock; Extravascular lung water(EVLW); Prognosis