ARDS患者液体理策略.pptVIP

Rivers E. N Engl J Med. 2001 Nov 8;345(19):1368-77. PiCCO监测提供容量负荷、心脏后负荷、心肌收缩力、肺水含量等信息 因此，低血容量休克时若以大量晶体液进行复苏，可以引起血浆蛋白稀释以及胶体渗透压下降，同时出现组织水肿 因此，成功治疗肺水肿取决于能否正确回答下列问题 Thus, the success of our therapy often depends on the correct answers to the following questions: (1) 肺组织水分是多少 (1) How much water is in the lungs, (2) 为何会有肺水肿 (2) Why is it there, (3) 如何使肺组织水分回到正常水平 (3) What can we do to return lung water to the normal limits Lung is a fairly dry place Make them dry Increase EVLW by only 200-300ml – ALI In ALI mortality approaches 100% if EVLW 14.3 ml/kg PBW on day 1 Make them dry Evidence strongl