Clinical value of extravascular pulmonary water index in predicting the prognosis of pulmonary infection patients complicated with acute respiratory distress syndrome / 中国基层医药

ABSTRACT

Objective@#To analyze the clinical value of extravascular pulmonary water index (EVLWI) in predicting the prognosis of pulmonary infection patients complicated with acute respiratory distress syndrome (ARDS).@*Methods@#From December 2016 to December 2018, 100 pulmonary infection patients complicated with ARDS admitted to Taizhou Central Hospital were selected in the study.According to the severity of the disease, they were divided into mild group (27 cases), moderate group (43 cases) and severe group (30 cases). According to the prognosis, they were divided into survival group (73 cases) and death group (27 cases). Both two groups received routine treatment, including general nutritional support, mechanical ventilation, circulatory support, glucocorticoid and pulmonary vasodilator.The patients were placed via subclavian vein, venous catheter and PiCCO catheter in femoral artery, and connected with PiCCO monitor.EVLWI was measured by pulmonary thermodilution.The SOFA score, APACHEⅡ score, EVLWI change and the prognosis of different EVLWI were observed and compared.@*Results@#The SOFA score[(13.54±3.21)points], APACHE Ⅱ score[(24.71±3.25)points], EVLWI [(19.36±3.97)mL/kg] in the severe group were higher than those in the mild group and moderate group, and SOFA score[(9.47±1.65)points], APACHEⅡ score[(17.65±3.98)points], EVLWI [(13.54±2.84)mL/kg] in the moderate group were higher than those in the mild group [(6.73±1.39)points, (12.03±2.54)points and (9.10±1.36)mL/kg], the differences were statistically significant (F=8.981, 17.245, 15.821, all P<0.05). The score of SOFA [(13.98±3.86)points], APACHE Ⅱ score[ (24.98±3.79)points], EVLWI [(19.84±3.21)mL/kg] in the death group were higher than those in the survival group [(7.85±1.54)points, (13.87±3.10)points and (10.08±1.87)mL/kg], the differences were statistically significant(t=11.404, 14.960, 18.816, all P<0.05). The SOFA score[(12.13±2.34)points] and APACHE Ⅱ score[(22.97±3.17)points] in the patients with EVLWI≥10mL/kg were higher than those in the patients with EVLWI<10mL/kg [(8.01±1.57)points and (15.42±3.64)points], the differences were statistically significant (t=10.442, 10.994, all P<0.05). The survival rate of EVLWI≥10mL/kg group (53.19%) was lower than that of EVLWI<10mL/kg group (90.57%), the difference was statistically significant(χ2=17.654, P<0.05).@*Conclusion@#EVLWI is high in pulmonary infection patients complicated with ARDS, and is closely correlated with disease and prognosis, which has good clinical value in predicting the prognosis of patients.