EVALUATION OF THE PORTABLE CHEST ROENTGENOGRAM FOR QUANTITATING EXTRAVASCULAR LUNG WATER IN CRITICALLY ILL ADULTS
EVALUATION OF THE PORTABLE CHEST ROENTGENOGRAM FOR QUANTITATING EXTRAVASCULAR LUNG WATER IN CRITICALLY ILL ADULTS
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DOI：
10.1378/chest.88.5.649
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发表时间：
1985-01-01
期刊：
影响因子：
9.6
通讯作者：
BLANK, NE
中科院分区：
文献类型：
--
作者：
HALPERIN, BD;FEELEY, TW;BLANK, NE
肺水肿的诊断通常是由胸部X线片上的特征性表现，即肺水增加而作出的。最佳的放射摄影技术取决于合作直立的病人，这是不可能的，大多数危重病人。这些患者也可能有多种放射学异常，使胸部X线片的解释困难。便携式胸部X线片准确识别过量肺水的存在和监测肺水变化的能力以前没有在插管和通气的危重成人中进行过评估，当胶片曝光时处于仰卧位。在12例患者中，对便携式胸部X线片上看到的肺水肿进行评分（0 ~ 390分），然后将其与使用热染料指示剂稀释技术测定血管外肺水进行比较。观察到线性相关（r = 0.51; p < 0.05; n = 73）。 放射学评分变化与肺水变化的评价显示无线性相关性（r = 0.1; p > 0.05）。虽然在上述条件下暴露的便携式胸部X线片是一种显示肺水肿的有用技术，但在监测危重患者肺水的适度变化时并不准确。
The diagnosis of pulmonary edema is frequently made from characteristic findings on the chest roentgenogram that suggest an increase in lung water. Optimal radiographic technique depends on a cooperative upright patient, which is not possible with most critically ill patients. These patients may also have multiple radiographic abnormalities that make interpretation of the chest roentgenogram difficult. The ability of portable chest roentgenograms to accurately identify the presence of excess lung water and monitor changes in lung water has not previously been evaluated in critically ill adults who are intubated and ventilated and in the supine position when the films are exposed. In 12 patients the pulmonary edema seen on portable chest roentgenograms was given a score (0 to 390 points), which was then compared with a determination of extravascular lung water using the thermal-dye indicator dilution technique. A linear correlation was observed (r = 0.51; p < 0.05; n = 73). Evaluation of a change in radiographic score vs a change in lung water showed no linear correlation (r = 0.1; p > 0.05). While portable chest roentgenograms exposed under the conditions described were a useful technique for demonstrating pulmonary edema, they were not accurate in monitoring modest changes in lung water in critically ill patients.