Effect of rhubarb on extravascular lung water in patients with acute respiratory distress syndrome

He, Jianxin; Si, Xiaoshui; Ji, Mingxia; Huang, Jing; Zheng, Wenjuan; Wang, Jiao; Wang, Junfeng; Zhu, Lijun

doi:10.1590/1806-9282.63.05.435

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ORIGINAL ARTICLES • Rev. Assoc. Med. Bras. 63 (5) • May 2017 • https://doi.org/10.1590/1806-9282.63.05.435 copy

Effect of rhubarb on extravascular lung water in patients with acute respiratory distress syndrome

Authorship SCIMAGO INSTITUTIONS RANKINGS

Summary

Objective:

The aim of this study was to evaluate the effect of rhubarb on extravascular lung water (EVLW) in patients with acute respiratory distress syndrome (ARDS).

Method:

A total of 80 patients with ARDS were randomly divided into a treatment group (40 cases) and control group (40 cases). Patients in the treatment group received rhubarb (30.0 g/d) and patients in the control group received conventional therapy for seven consecutive days. Extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI) were determined using pulse contour cardiac output (PiCCO) technology, and the oxygenation index was measured by blood gas analysis at baseline and on days 3, 5 and 7 after treatment.

Results:

The oxygenation index was higher and the levels of EVLWI and PVPI were lower after treatment in the two groups; however, these indexes showed significant differences on the 5^th and 7^th days after rhubarb treatment compared with the results in the control group (p<0.05).

Conclusion:

Rhubarb can decrease EVLWI and PVPI, and improve oxygenation in patients with ARDS.

Keywords:
rhubarb; ARDS; EVLWI; oxygenation index

Group	Cases (n)	Sex (male/female)	Age (years old)	Weight (kg)	Height (cm)	PEEP (cmH2O)	APACHE II score (points)	Oxygenation index
Treatment group	40	25/15	(59±12)	65±7	168±10	9.8±2.5	19.5±2.5	115±26
Control group	40	22/18	(57±10)	68±6	170±10	10.5±2.4	19.8±2.3	110±27
χ² value		0.22	0.18	0.11	0.82	1.58	0.64	0.06
p-value		0.45	0.67	0.74	0.417	0.21	0.43	0.81

Index	Group	Cases (n)	Baseline (pre-treatment)	Day 3 after treatment	Day 5 after treatment	Day 7 after treatment
EVLWI (mL/kg)	Treatment group	40	12.4±4.1	9.5±3.8	6.3±2.6^a a p<0.05; compared with the control group, ,^b b p<0.05.	4.7±2.2^a a p<0.05; compared with the control group, ,^b b p<0.05.
EVLWI (mL/kg)	Control group	40	11.7±4.8	9.3±4.1	8.4±2.7^a a p<0.05; compared with the control group,	7.1±1.9^a a p<0.05; compared with the control group,
PVPI	Treatment group	40	6.0±0.8	4.6±1.4	2.8±0.9^a a p<0.05; compared with the control group, ,^b b p<0.05.	1.7±0.8^a a p<0.05; compared with the control group, ,^b b p<0.05.
PVPI	Control group	40	5.0±0.9	4.7±1.2	3.8±0.8^a a p<0.05; compared with the control group,	2.7±0.7^a a p<0.05; compared with the control group,
Oxygenation index (mmHg)	Treatment group	40	115±24	128±31^a a p<0.05; compared with the control group,	186±32^a a p<0.05; compared with the control group, ,^b b p<0.05.	294±51^a a p<0.05; compared with the control group, ,^b b p<0.05.
Oxygenation index (mmHg)	Control group	40	113±25	125±32^a a p<0.05; compared with the control group,	167±27^a a p<0.05; compared with the control group,	212±50^a a p<0.05; compared with the control group,

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[1] *Correspondence: Critical Care Medicine, Yiwu Central Hospital, Address: No. 699 Jiangdong Road Yiwu, Zhejiang Province - China. Postal code: 322000. jxcndoc@163.com