Therapeutic influence of colloids on extravascular lung water and oxygenation functions in patients with severe sepsis
Authors:
Martin Doleček; Petr Svoboda; Ilona Kantorová; Igor Sas; Jitka Bíbrová
Authors place of work:
Úrazová nemocnice v Brně, Ponávka 6, Brno, 662
Trauma Hospital Brno, Czech Republic
50
Published in the journal:
Úraz chir. 16., 2008, č.4
Summary
Background:
Recent studies demonstrated that extravascular lung water is a reliable and independent marker for outcome critical ill patients. Colloid osmotic pressure is important force influencing the solution transport across altered capillary wall. There is correlation between hypoproteinemia, fluid retention, incidence of ARDS and mortality in septic patients. Administration of colloids can maintain, or increase colloid osmotic pressure levels in opposite to crystaloids, whose administration always leads to next decrease of colloid osmotic pressure.
Methods:
Randomized controlled single centre trial. It was investigated the efficacy of colloids on evolution of extravascular lung water and oxygenation functions in patient with severe sepsis with artificial ventilation and with extravascular lung water above normal levels. Patients were randomly allocated to a group ALBUMIN (n=30), or VOLUVEN (n=26). Data were collected at +6, +12, +24, +36, +48, +72 hours after start of study drug administration.
Main results:
A total of 56 patients were studied. We observed significant decrease of ex-travascular lung water in ALBUMIN group in whole monitored period. There were no significant changes in VOLUVEN group. Despite it was observed in both groups significant correlation between extravacular lung water and PaO2/FiO2 or AaDO2. We did observe no difference in mortality in both groups.
Conclusion:
We can summarize that albumin reduce the amount of extravascular lung water for more and earlier than Voluven. But we noted improvement of oxygenation functions in both groups. Correlation between extravascular lung water and water and PaO2/FiO2 or AaDO2 was significant in both groups.
Key words:
extravascular lung water, severe sepsis, 20% albumin, 6% Voluven, AaDO2, PaO2/FiO2.
Zdroje
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