Systemic Capillary Leak Syndrome associated with hypovolemic shock and compartment syndrome. Use of transpulmonary thermodilution technique for volume management.
Systemic Capillary Leak Syndrome (SCLS) is a rare disorder characterized by increased capillary hyperpermeability leading to hypovolemic shock due to a markedly increased shift of fluid and protein from the intravascular to the interstitial space. Hemoconcentration, hypoalbuminemia and a monoclonal gammopathy are characteristic laboratory findings. Here we present a patient who suffered from SCLS with hypovolemic shock and compartment syndrome of both lower legs and thighs. Volume and catecholamine management was guided using transpulmonary thermodilution. Extended hemodynamic monitoring for volume and catecholamine management as well as monitoring of muscle compartment pressure is of crucial importance in SCLS patients.
Saugel
Bernd
B
II Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str, 22, D-81675 München, Germany. bernd.saugel@lrz.tu-muenchen.de
Umgelter
Andreas
A
Martin
Friedrich
F
Phillip
Veit
V
Schmid
Roland M
RM
Huber
Wolfgang
W
D000328:Adult; D019559:Capillary Leak Syndrome / Q000150:complications*; D003161:Compartment Syndromes / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D012769:Shock / Q000209:etiology* / Q000628:therapy*; D013815:Thermodilution / Q000379:methods*