| Japanese |
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| Title | 肺水腫の治療-心原性, 非心原性肺水腫の診断から- |
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| Subtitle | 特集 誌上シンポジウム/肺水腫 |
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| Authors | 相馬一亥*, 劔物修** |
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| Authors(kana) | |
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| Organization | *北里大学病院ICU・CCU内科, **北里大学病院ICU・CCU麻酔科 |
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| Journal | 循環制御 |
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| Volume | 5 |
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| Number | 2 |
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| Page | 167-173 |
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| Year/Month | 1984/ |
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| Article | 報告 |
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| Publisher | 日本循環制御研究会 |
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| Abstract | 「要旨」肺水腫は大きく心原性肺水腫と非心原性肺水腫の2つに分類される. 心原性肺水腫の治療は前負荷, 後負荷そして心機能の改善が必要である. 心原性肺水腫の肺血管外水分量の増大は肺毛細血管内圧の上昇によるものであり, 血管拡張薬, 利尿薬, 変力作用薬物の投与などによりその改善をはかる. 一方, 非心原性肺水腫は肺血管内皮の障害によって蛋白の透過性亢進のために生ずるものであり, その原因は不明である. 非心原性肺水腫の治療は原疾患およびその合併症の治療である. 循環管理としては心拍出量が低下しないレベルまで肺毛細血管内圧を維持すること, 呼吸管理としては持続陽圧呼吸やhigh-frequency ventilationなどによりFiO2を0.5以下にすること, 合併症としては播種性血管内凝固の早期診断, 早期治療が重要である. 原因に対する治療としては肺血管内皮の障害の把握と, その過程をブロックする治療が確立されねばならない. 「I. 分類」肺水腫は1, 2)大きく2つに分類される. |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Management of pulmonary edema based on differential diagnosis of cardiogenic and noncardiogenic forms |
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| Subtitle | |
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| Authors | Kazui Soma*, Osamu Kemmotsu** |
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| Authors(kana) | |
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| Organization | *Intensive Care Unit, Kitasato University Hospital, Department of Internal Medicine, **Intensive Care Unit, Kitasato University Hospital, Anesthesiology, Kitasato University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 5 |
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| Number | 2 |
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| Page | 167-173 |
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| Year/Month | 1984/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Physiologically, pulmonary edema can be classified into hydrostatic, (cardiogenic, highpressure) and permeability (noncardiogenic, low-pressure) forms. It is clear that the formation of pulmonary edema involves the flow of fluid from the vascular space into the interstitial or alveolar spaces. The treatment of cardiogenic pulmonary edema is well known and fairly standard. A major advance is that of improving cardiac function by decreasing left ventricular afterload, thereby permitting the heart to function on a new ventricular function curve at a lower enddiastolic pressure. In noncardiogenic pulmonar yedema, increased extravascular lung water originates from an acute injury to the alveolo-capillary “barrier” membrane which separates the intravascular compartment from the pulmonary interstitium and alveoli. The noncardiogenic pulmonary edema is also associated with other changes in the pulmonary vasculature. Improved method for detecting increaed lung water, quantifying pulmonary transvascular protein flux, or detecting complement activation in a clinical setting may prove valuable for the early diagnosis of noncardiogenic pulmonary edema. |
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| Practice | Basic medicine |
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| Keywords | pulmonary edema, cardiogenic, noncardiogenic, diagnosis, therapy |
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