[Evaluation of cardiogenic pulmonary edema by extravascular lung water during noninvasive positive pressure ventilation].
Noninvasive positive pressure ventilation (NPPV) has recently been applied to patients with left ventricular dysfunction. We report a female patient who showed low cardiac output syndrome and pulmonary hypertension after cardiac surgery. After tracheal extubation, she developed cardiogenic pulmonary edema associated with an increase in extravascular lung water (EVLW). NPPV temporally improved pulmonary edema and respiratory distress, and decreased EVLW. However, once we weaned her from NPPV EVLW increased and pulmonary edema was revealed. On post-operative day 9, we finally weaned her from NPPV when baseline value of EVLW became small, probably due to supportive therapy including afterload reduction. We suggest that, in patients with left ventricular dysfunction, NPPV should be considered and EVLW may be a useful parameter to adjust the support.
Shimpuku
Genji
G
Surgical Intensive Care Unit, National Cardiovascular Cente, Suita.
Tachibana
Kazuya
K
Imanaka
Hideaki
H
Takeuchi
Muneyuki
M
D000768:Anesthesia, General; D015415:Biomarkers / Q000032:analysis; D002303:Cardiac Output, Low / Q000628:therapy; D006348:Cardiac Surgical Procedures; D015633:Extravascular Lung Water / Q000378:metabolism*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000628:therapy; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications / Q000628:therapy*; D011654:Pulmonary Edema / Q000175:diagnosis* / Q000628:therapy*; D018487:Ventricular Dysfunction, Left / Q000628:therapy
D015415:Biomarkers