Extravasation of body fluids

Introduction Capillary leak syndrome is a serious complication of systemic inflammatory response syndrome. It is characterized by leakage of body fluids and proteins from the blood vessels of the body into the interstitial space. It is clinically manifested as systemic skin and mucous membranes. Sexual edema, massive exudation of the chest and abdomen, oliguria, hypotension, hypoxemia and hypoproteinemia can affect multiple organs throughout the body.

Cause

There are many causes of CLS, which are common in severe trauma, sepsis, after cardiopulmonary bypass (especially after cardiopulmonary bypass in infants) and reperfusion injury, snake bite, acute lung injury or acute respiratory distress syndrome ( ARDS), burns, are also the pathways for the toxic effects of many drugs such as recombinant interleukin-2 and docetaxel.

an examination

Related inspection

Blood test respiratory exercise check

Systemic CLS is uniquely clinical and involves multiple important organs. The basis for early diagnosis is summarized as:

1 progressive decline in blood pressure caused by other causes within 24 hours after surgery (such as low cardiac output syndrome, pericardial tamponade, venous return obstruction, etc.);

2 increase in the amount of non-hemorrhagic colloid;

3 severe edema of the skin and mucous membranes, conjunctival edema, increased tears, plasma-like, weight gain, pleural effusion, ascites, pericardial effusion, etc.;

4 hypoxemia;

5X chest radiograph showed interstitial exudative changes in the lung;

6 laboratory tests showed a decrease in plasma protein.

Differential diagnosis

CLS should be distinguished from the systematic systemic Capillary Leak Syndrome (SCLS) reported in the literature. SCLS was first reported by Clarkson et al in 1960. It can be recurrent without inducement and is a rare group of unexplained low causes. Volumetric hypotension, blood concentration, non-proteinuria hypoproteinemia, systemic edema, and clinical syndrome with atypical globulinemia in most cases. In severe cases, heart, lung, kidney and other important organ failures may occur, and may progress to multiple myeloma, which has a high mortality rate. SCLS is also caused by increased capillary permeability, but the specific pathogenesis is unclear. Terbutaline (beta 2 receptor agonist) and theophylline can improve symptoms and prevent their onset.

Systemic edema, hypoproteinemia, blood pressure and central venous pressure are reduced, weight gain, blood concentration, and multiple organ failure can occur in severe cases.

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