Abstract: A male patient undergoing extracorporeal ultrasound lithotripsy developed the symptoms of dyspnea, low blood
pressure, palpitations, chest tightness, and sweating, and a clinical diagnosis of pulmonary capillary leak and hypovolemic
shock was made. Pulse indicator continuous cardiac output (PiCCO) technique was used for resuscitation according to the
measurements of extravascular lung water index (EVLWI) and global end-diastolic volume index (GEDI). The patient showed
low levels of cardiac output (CO) and GEDI with a peak EVLWI of 32 ml/kg and profuse pink and thin sputum overflow from
the trachea. The high ventilator support parameters failed to correct low oxygen saturation. Restricted fluid infusion was used
to reduce pulmonary edema. Colloidal solution was given when GEDI was below 500 ml/m2, and the volume and fluid
infusion rate were reduced for a GEDI higher than 500 ml/m2. Pulmonary edema was gradually reduced after the treatments
with improvement of lactic acid level and liver and kidney functions. Vasopressors were withdrawn 6 days later, mechanical
ventilation was discontinued 10 days later, and tracheal intubation was removed 25 days later, after which the patient was
discharged. In the treatment of the patient, PiCCO monitoring played an important role.