Study of the role of catecholamines and their intermediate metabolites in the pathogenesis of neurogenic pulmonary edema in ICU

CHEN Guang-hui; ZHENG Hua; TANG Su-yu; WANG Zhen-zhen

doi:10.13820/j.cnki.gdyx.20241162

Abstract：Objective To explore the role of catecholamine and its intermediate metabolites in the development of neurogenic pulmonary edema in the intensive care unit(ICU).Methods Clinical data were collected from 32 pa-tients diagnosed with neurogenic pulmonary edema in the ICU between January 2020 and December 2023,forming the study group.Another 32 ICU patients from the same period who did not develop neurogenic pulmonary edema were select-ed as the control group.A retrospective analysis was conducted on the clinical data of both groups,comparing differences in blood gas indices,hemodynamic parameters,relevant laboratory indicators,inflammatory factors,and levels of cate-cholamines and their intermediate metabolites.Results Compared to the control group,the study group showed signifi-cant increases in partial pressure of carbon dioxide in arterial blood(PaCO2),fraction of inspiration O2(FiO2),artery-alveolar oxygen partial pressure gradient(A-aDO2),respiratory rate(RR),pulmonary artery wedge pressure(PAWP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),total catecholamines,epinephrine,metaneph-rine,normetanephrine,and norepinephrine,while partial pressure of oxygen in arterial blood(PaO2),arterial oxygen sat-uration(SaO2),arterial/alreolar oxygen tension ratio(a/APO2),PaO2/FiO2,and interferon-γ(IFN-γ)were signifi-cantly decreased(P＜0.05).No significant difference was observed in central venous pressure(CVP)levels between the groups(P＞0.05).Correlation analysis indicated that epinephrine,norepinephrine,metanephrine,total catecholamines,and normetanephrine were positively correlated with PaCO2,FiO2,and A-aDO2,and negatively correlated with PaO2,SaO2,a/APO2,and PaO2/FiO2(P＜0.05).Conclusion Catecholamines and their intermediate metabolites are signifi-cantly elevated in ICU patients with neurogenic pulmonary edema and are correlated with blood gas indices,playing an im-portant role in the occurrence and progression of the disease.