{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T07:19:26Z","timestamp":1648797566788},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"16","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Anamnese und klinischer Befund\u2002Wir berichten von einer 27-j\u00e4hrigen Patientin, die im Rahmen einer Pneumonie ein akutes Lungenversagen entwickelte. \u00dcber eine transpulmonale Thermodilutionsmethode konnte ein erh\u00f6htes extravasales Lungenwasser (17\u200aml\/kg) festgestellt werden. Die Patientin erhielt eine kalkulierte antibiotische Therapie, wurde Lungen-protektiv beatmet und eine Negativbilanzierung wurde angestrebt. Im Verlauf kam es zu einer respiratorischen Verbesserung bei r\u00fcckl\u00e4ufigen Entz\u00fcndungsparametern und einem reduzierten extravasalen Lungenwasser (10\u200aml\/kg). Im weiteren Verlauf stieg jedoch das extravasale Lungenwasser deutlich an (29\u200aml\/kg).<\/jats:p><jats:p>Untersuchungen und Diagnose\u2002In der R\u00f6ntgen-Thorax-Aufnahme war die Spitze des zentralen Venenkatheters in die Vena jugularis interna disloziert. 7 Tage zuvor hatte sich die Katheterspitze korrekt auf die Vena cava superior projiziert.<\/jats:p><jats:p>Therapie und Verlauf\u2002Nach Neu-Anlage des zentralen Venenkatheters konnte wieder ein extravasales Lungenwasser von 10\u200aml\/kg gemessen werden. Nach insgesamt 10 Behandlungstagen auf Intensivstation konnte die Patientin erfolgreich extubiert werden.<\/jats:p><jats:p>Folgerung\u2002Als Mechanismus f\u00fcr die Katheterspitzen-Dislokation kommen ein Valsalva-Man\u00f6ver der Patientin oder spontane Bewegungen des Oberk\u00f6rpers infrage. Bei einem pl\u00f6tzlichen Anstieg des extravasalen Lungenwassers muss differenzialdiagnostisch eine Dislokation der Spitze des zentralen Venenkatheters in Betracht gezogen und radiologisch ausgeschlossen werden.<\/jats:p>","DOI":"10.1055\/a-1189-7042","type":"journal-article","created":{"date-parts":[[2020,8,13]],"date-time":"2020-08-13T22:31:20Z","timestamp":1597357880000},"page":"1187-1190","source":"Crossref","is-referenced-by-count":0,"title":["Unerwarteter Anstieg des extravasalen Lungenwassers nach akutem\u00a0Lungenversagen"],"prefix":"10.1055","volume":"145","author":[{"given":"Veit-Simon","family":"Eckle","sequence":"additional","affiliation":[{"name":"Medizinische Klinik mit Schwerpunkt Infektiologie und\u00a0Pneumologie, Charit\u00e9-Universit\u00e4tsmedizin Berlin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Witzenrath","sequence":"additional","affiliation":[{"name":"Medizinische Klinik mit Schwerpunkt Infektiologie und\u00a0Pneumologie, Charit\u00e9-Universit\u00e4tsmedizin Berlin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"M\u00fcller-Redetzky","sequence":"additional","affiliation":[{"name":"Medizinische Klinik mit Schwerpunkt Infektiologie und\u00a0Pneumologie, Charit\u00e9-Universit\u00e4tsmedizin Berlin"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,8,13]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/ACO.0000000000000408","article-title":"Hemodynamic monitoring in thoracic surgical patients","volume":"30","author":"J Raphael","year":"2017","journal-title":"Current Opinion in Anesthesiology"},{"key":"ref2","first-page":"274","article-title":"Extravascular lung water in ARDS patients","volume":"79","author":"S G Sakka","year":"2013","journal-title":"Minerva Anestesiol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1055\/s-0042-101873","article-title":"Behandlung von erwachsenen Patienten mit ambulant erworbener Pneumonie und Pr\u00e4vention \u2013 Update 2016","volume":"70","author":"S Ewig","year":"2016","journal-title":"Pneumologie"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/s00063-014-0347-2","article-title":"Standard-pO2 zur Unterscheidung von prim\u00e4rer und sekund\u00e4rer Hypox\u00e4mie","volume":"109","author":"N Frost","year":"2014","journal-title":"Med Klin Intensivmed Notfmed"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1007\/s00101-005-0924-0","article-title":"Messung des Herzzeitvolumens","volume":"54","author":"D A Reuter","year":"2005","journal-title":"Der Anaesthesist"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s10877-012-9378-5","article-title":"The transpulmonary thermodilution technique","volume":"26","author":"S G Sakka","year":"2012","journal-title":"Journal of Clinical Monitoring and Computing"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s13613-015-0081-9","article-title":"xtravascular lung water in critical care: recent advances and clinical applications","volume":"5","author":"M Jozwiak","year":"2015","journal-title":"Annals of Intensive Care"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1631\/jzus.B1500167","article-title":"Impact of misplaced subclavian vein catheter into jugular vein on transpulmonary thermodilution measurement variables","volume":"17","author":"W Q Yu","year":"2016","journal-title":"Journal of Zhejiang University: Science B"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s10877-015-9762-z","article-title":"Influence of different infracardial positions of central venous catheters in hemodynamic monitoring using the transpulmonal thermodilution method","volume":"30","author":"P Kellner","year":"2016","journal-title":"Journal of Clinical Monitoring and Computing"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1055\/s-0028-1109742","article-title":"Risk of extravasation after power injection of contrast media via the proximal port of multilumen central venous catheters: case report and review of the literature","volume":"182","author":"C Schummer","year":"2010","journal-title":"Rofo"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13586","article-title":"B-Lines for the assessment of extravascular lung water: Just focused or semi-quantitative?","author":"A Seibel","year":"2020","journal-title":"Acta Anaesthesiol Scand"}],"container-title":["DMW - 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