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Abstract：
OBJECTIVE: Capillary leak syndrome (CLS) is characterized by severe systemic edema without specific treatment, resulting in a high mortality rate. This study investigated whether there is organ edema in neonatal CLS patients and specific treatment strategies to improve patient prognosis.
METHODS: Thirty-seven newborns diagnosed with CLS were included in this study. (1) Routine point-of-care ultrasound (POCUS) was used to identify whether the patients had visceral edema or fluid collection. (2) All patients were treated with 3% NaCl intravenously, and the clinical manifestations, laboratory indices and outcomes were compared before and after treatment.
RESULTS: (1) Diffuse severe edema was found in 92.0% of the patients. (2) The POCUS examination revealed that CLS patients exhibited significant visceral edema in addition to diffuse severe edema, which included pulmonary edema in 67.6%, cerebral edema in 37.8%, severe intestinal edema in 24.3%, severe myocardial edema in 8.1%, pericardial effusion in 5.4%, pleural effusion in 29.7% and peritoneal effusion in 18.9%. Two patients (5.45%) had only myocardial edema without other manifestations. (3) Before and after the intravenous injection of 3% NaCl, there were no significant differences in the serum sodium or potassium levels of CLS patients, while the hemoglobin and hematocrit levels were significantly lower after treatment (p < 0.01). Her plasma ALB concentration and arterial pressure returned to normal levels after the treatment was completed. (4) All the patients survived, and no side effects or complications were observed during or after treatment with 3% NaCl.
CONCLUSIONS: (1) In addition to diffuse severe edema, visceral edema and effusion are common and important clinical manifestations of neonatal CLS and need to be detected by routine POCUS. (2) The intravenous injection of 3% NaCl is a safe, effective and specific treatment strategy for neonatal CLS, with a survival rate of 100% and no adverse effects.
METHODS: Thirty-seven newborns diagnosed with CLS were included in this study. (1) Routine point-of-care ultrasound (POCUS) was used to identify whether the patients had visceral edema or fluid collection. (2) All patients were treated with 3% NaCl intravenously, and the clinical manifestations, laboratory indices and outcomes were compared before and after treatment.
RESULTS: (1) Diffuse severe edema was found in 92.0% of the patients. (2) The POCUS examination revealed that CLS patients exhibited significant visceral edema in addition to diffuse severe edema, which included pulmonary edema in 67.6%, cerebral edema in 37.8%, severe intestinal edema in 24.3%, severe myocardial edema in 8.1%, pericardial effusion in 5.4%, pleural effusion in 29.7% and peritoneal effusion in 18.9%. Two patients (5.45%) had only myocardial edema without other manifestations. (3) Before and after the intravenous injection of 3% NaCl, there were no significant differences in the serum sodium or potassium levels of CLS patients, while the hemoglobin and hematocrit levels were significantly lower after treatment (p < 0.01). Her plasma ALB concentration and arterial pressure returned to normal levels after the treatment was completed. (4) All the patients survived, and no side effects or complications were observed during or after treatment with 3% NaCl.
CONCLUSIONS: (1) In addition to diffuse severe edema, visceral edema and effusion are common and important clinical manifestations of neonatal CLS and need to be detected by routine POCUS. (2) The intravenous injection of 3% NaCl is a safe, effective and specific treatment strategy for neonatal CLS, with a survival rate of 100% and no adverse effects.
摘要：
目的：毛细血管渗漏综合征（CLS）的特征是严重的全身性水肿，无需特殊治疗。导致高死亡率。这项研究调查了新生儿CLS患者是否存在器官水肿以及改善患者预后的具体治疗策略。
方法：本研究纳入37例诊断为CLS的新生儿。（1）常规点护理超声（POCUS）用于确定患者是否存在内脏水肿或积液。(2)所有患者均静脉注射3%NaCl,和临床表现，比较治疗前后的实验室指标和结局.
结果：(1)92.0%的患者出现弥漫性严重水肿。（2）POCUS检查显示，CLS患者除弥漫性重度水肿外，还表现出明显的内脏水肿。其中肺水肿占67.6%，脑水肿37.8%,严重的肠道水肿占24.3%，严重的心肌水肿占8.1%，心包积液占5.4%，胸腔积液占29.7%,腹腔积液占18.9%。2例（5.45％）仅有心肌水肿，无其他表现。(3)静脉注射3%NaCl前后,CLS患者的血清钠或钾水平没有显着差异，治疗后血红蛋白和血细胞比容水平明显降低(p<0.01)。治疗完成后，她的血浆ALB浓度和动脉压恢复到正常水平。(4)患者全部存活,在用3％NaCl治疗期间或之后均未观察到副作用或并发症。
结论：(1)除弥漫性重度水肿外，内脏水肿和积液是新生儿CLS常见且重要的临床表现，需要通过常规POCUS进行检测。(2)静脉注射3%NaCl是安全的,新生儿CLS的有效和具体的治疗策略，成活率100%，无不良反应。
方法：本研究纳入37例诊断为CLS的新生儿。（1）常规点护理超声（POCUS）用于确定患者是否存在内脏水肿或积液。(2)所有患者均静脉注射3%NaCl,和临床表现，比较治疗前后的实验室指标和结局.
结果：(1)92.0%的患者出现弥漫性严重水肿。（2）POCUS检查显示，CLS患者除弥漫性重度水肿外，还表现出明显的内脏水肿。其中肺水肿占67.6%，脑水肿37.8%,严重的肠道水肿占24.3%，严重的心肌水肿占8.1%，心包积液占5.4%，胸腔积液占29.7%,腹腔积液占18.9%。2例（5.45％）仅有心肌水肿，无其他表现。(3)静脉注射3%NaCl前后,CLS患者的血清钠或钾水平没有显着差异，治疗后血红蛋白和血细胞比容水平明显降低(p<0.01)。治疗完成后，她的血浆ALB浓度和动脉压恢复到正常水平。(4)患者全部存活,在用3％NaCl治疗期间或之后均未观察到副作用或并发症。
结论：(1)除弥漫性重度水肿外，内脏水肿和积液是新生儿CLS常见且重要的临床表现，需要通过常规POCUS进行检测。(2)静脉注射3%NaCl是安全的,新生儿CLS的有效和具体的治疗策略，成活率100%，无不良反应。
