Reserch On Correlation Between Oxygenation Index And EVLW In Acute Respiratory Distress Syndrome Patients

Objective To reserch on Correlation Between oxygenation index (OI) and to study of ARDS patients with extravascular lung water to reflect its oxygenation, we apply extravascular lung water as a new index instead of oxygenation index to scientifically guide the ARDS patients with care,and to reduce patient pain,the cost and the workload of nurses.Method:This experiment from Jan.2010to Dec.2011admitted in the first hospital of Guangxi Medical University intensive medicine two District line pulse contour temperature diluted continuous cardiac output measurement techniques (PiCCO) monitoring of ARDS patients in43cases. We collected of patients in general information, including sex, age, occupation, marital status, education, economic status, original disease, severity of illness, treatment method. In section24h, patients and their family members agreed, contraindications excluded after pulse contour temperature dilution of continuous cardiac output measurement (PiCCO) monitoring. Every8hours we used transpulmonary thermodilution technique in monitoring patients with continuous parameters:global end-diastolic volume (GEDV), intrathoracic blood volume (ITBV), extravascular lung water (EVLW), pulmonary vascular permeability index (PVPI). In patients with continuous cardiac output changes and changes in conditions with a large calibration, We monitored one. Two groups of patients in each transpulmonary thermodilution monitoring global end-diastolic volume (GEDV), intrathoracic blood volume (ITBV), extravascular lung water (EVLW), pulmonary vascular permeability index (PVPI), nurse punctured radial artery blood gas analysis, through the PaO2/FiO2to calculate the oxygenation index (OI). In addition,we record ARDS patients for blood gas analysis, PiCCO monitoring frequency. Calculation of ARDS patients for blood gas analysis, PiCCO monitoring cost.We collected information related to a patient, to build up a database, using descriptive analysis, t test, ANOVA, chi-square test, regression and correlation, multiple linear regression analysis and other statistical methods, to compare two groups of patient’s oxygenation index (OI), global end-diastolic volume (GEDV), intrathoracic blood volume (ITBV), blood vessels lung water (EVLW), pulmonary vascular permeability index (PVPI) for comparative analysis. In addition, we statisticsed the statistical analysis of the ARDS patients for blood gas analysis, PiCCO monitoring frequency and blood gas analysis comparison of ARDS patients, PiCCO monitoring cost.Resul1. The oxygenation index and oxygen saturation were positively correlated (P<0.05);The oxygenation index and respiratory frequency, extravascular lung water, pulmonary vascular permeability index were negative correlation (P<0.05); The oxygenation index and heart rate, mean arterial pressure, intrathoracic blood volume, global end-diastolic volume (P>0.05) were no correlation.2. Patients with ARDS oxygenation index and related factors of simple linear regression analysis Patients with ARDS oxygenation index and respiratory rate, oxygen saturation, extravascular lung water, pulmonary vascular permeability index exists linear relationship (P<0.05), oxygenation index and heart rate, mean arterial pressure, intrathoracic blood volume, global end-diastolic volumewere not related(P>0.05).3. Patients with ARDS oxygenation index and related factors of multivariate linear regression analysis Patients with ARDS oxygenation index and extravascular lung water,mean arterial pressure,pulmonary vascular permeability index in linear regression was statistically significant (P<0.05).4. Patients with ARDS extravascular lung water related factors multivariate linear regression analysis Patients with ARDS extravascular lung water and pulmonary vascular permeability index linear regression was statistically significant (P<0.05), intrathoracic blood volume, global end-diastolic volume on ARDS extravascular lung water in patients with no effect (P>0.05).5. Blood gas analysis and monitoring of PiCCO titer comparison Blood gas analysis unit costs about169yuan, PiCCO monitoring cost unit price of about220yuan. In43patients with ARDS per capita for blood gas analysis for the number35.74+9.299, the per capita PiCCO monitoring for the number24.42+6.423, which had a significant difference (t=6.571, P=0.000). In43patients with ARDS per capita for blood gas analysis of total costs for the6040.77+1571.615yuan,43patients with ARDS per capita of line PiCCO monitoring costs5372.09+1412.961yuan, two cost comparison difference has statistics significance (t=2.075, P=0.041).Conclusion1.In ARDS patients,the oxygenation index were significantly associated with the mean arterial pressure, extravascular lung water, pulmonary vascular permeability index. The extravascular lung water is the determinants of oxygenation index.2.Patients with ARDS monitoring can use of extravascular lung water index instead of oxygenation index. Extravascular lung water with oxygenation index is more superiority.