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首页> 美国卫生研究院文献>Springer Open Choice >Estimation of extravascular lung water using the transpulmonary ultrasound dilution (TPUD) method: a validation study in neonatal lambs
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Estimation of extravascular lung water using the transpulmonary ultrasound dilution (TPUD) method: a validation study in neonatal lambs

机译：经肺超声稀释（TPUD）方法估算血管外肺水：新生儿羔羊的验证研究

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Increased extravascular lung water (EVLW) may contribute to respiratory failure in neonates. Accurate measurement of EVLW in these patients is limited due to the lack of bedside methods. The aim of this pilot study was to investigate the reliability of the transpulmonary ultrasound dilution (TPUD) technique as a possible method for estimating EVLW in a neonatal animal model. Pulmonary edema was induced in 11 lambs by repeated surfactant lavages. In between the lavages, EVLW indexed by bodyweight was estimated by TPUD (EVLWItpud) and transpulmonary dye dilution (EVLWItpdd) (n = 22). Final EVLWItpud measurements were also compared with EVLWI estimations by gold standard post mortem gravimetry (EVLWIgrav) (n = 6). EVLWI was also measured in two additional lambs without pulmonary edema. Bland–Altman plots showed a mean bias between EVLWItpud and EVLWItpdd of −3.4 mL/kg (LOA ± 25.8 mL/kg) and between EVLWItpud and EVLWIgrav of 1.7 mL/kg (LOA ± 8.3 mL/kg). The percentage errors were 109 and 43 % respectively. The correlation between changes in EVLW measured by TPUD and TPDD was r2 = 0.22. Agreement between EVLWI measurements by TPUD and TPDD was low. Trending ability to detect changes between these two methods in EVLWI was questionable. The accuracy of EVLWItpud was good compared to the gold standard gravimetric method but the TPUD lacked precision in its current prototype. Based on these limited data, we believe that TPUD has potential for future use to estimate EVLW after adaptation of the algorithm. Larger studies are needed to support our findings.
机译：血管外肺水（EVLW）增加可能会导致新生儿呼吸衰竭。由于缺乏床旁检查方法，这些患者的EVLW准确测量受到限制。这项初步研究的目的是研究经肺超声稀释（TPUD）技术作为评估新生动物模型中EVLW的可能方法的可靠性。反复灌洗表面活性剂可诱发11只羊羔的肺水肿。在两次灌洗之间，通过TPUD（EVLWItpud）和经肺染料稀释液（EVLWItpdd）（n = 22）估算以体重指数表示的EVLW。最终的EVLWItpud测量值也与通过黄金标准死后重量分析法（EVLWIgrav）（n = 6）进行的EVLWI估计值进行了比较。在另外两只没有肺水肿的羔羊中也测量了EVLWI。 Bland-Altman图显示EVLWItpud和EVLWItpdd之间的平均偏差为-3.4 mL / kg（LOA±25.8 mL / kg），EVLWItpud和EVLWIgrav之间的平均偏差为1.7 mL / kg（LOA±8.3 mL / kg）。百分比误差分别为109％和43％。 TPUD和TPDD测量的EVLW变化之间的相关性为r 2 = 0.22。 TPUD和TPDD进行的EVLWI测量之间的一致性很低。在EVLWI中检测这两种方法之间的变化的趋势能力值得怀疑。与金标准重量分析法相比，EVLWItpud的准确性不错，但TPUD在其当前原型中缺乏精度。基于这些有限的数据，我们认为TPUD在算法适应后有潜力将来用于估算EVLW。需要更大的研究来支持我们的发现。

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