Change And Value Of Extravascular Lung Water In Infant With Congenital Heart Disease After Cardiopulmonary Bypass

Object:The Pulse Contour Continuous Cardiac Output (PiCCO) monitor is used to measure the level of extravascular lung water (EVLW) at the early stage after the cardiopulmonary bypass (CPB) surgery of infants with congenital heart diseases and understand the clinical value of extravascular lung water at the early stage after the cardiopulmonary bypass surgery.Method:Select 18 cases of infants with congenital heart diseases who have undergone the cardiopulmonary bypass surgery for congenital heart diseases from August 2009 to April 2010 in the Affiliated Children's Hospital of Zhejiang University School of Medicine and use the Pulse Contour Continuous Cardiac Output monitor to measure the extravascular lung water at 0,4,8,12,24 and 48 hours after the cardiopulmonary bypass surgery and measure the pulmonary vascular permeability index (PVPI), cardiac index (CI), left atrial pressure (LAP), central venous pressure (CVP), and PaO2/FiO2. Result:11 cases of male infants and 7 cases of female infants, age 4 to 36 (11.3±8.68) months, weight 4 to 16 (7.94±3.09) kg, all have undergone radical cardiopulmonary bypass surgeries, period of cardiopulmonary bypass 84.9±28.4min, period of mechanical ventilator 22.06±16.34h, ICU staying period 5.06±1.43d, successfully leave the hospital. EVLW is 5-23ml/kg(12.46±3.90), which is obviously bigger than 7.0ml/kg. None of 9 infants with EVLW≥15ml/kg die. EVLW shows significant positive relation to PVPI (p<0.001), significant negative relation to PaO2/FiO2 (p <0.01). CI, CVP and LAP have no relation to EVLW (p>0.05).Conclusion:EVLW of infants with congenital heart diseases after CPB surgery is obviously higher than the normal value. EVLW is related to PVPI and PaO2/FiO2 and has instructive significance for clinical treatment.