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Brown LM, Calfee CS, Howard JP, et al. Comparison of thermodilution measured extravascular lung water with chest radiographic assessment of pulmonary oedema in patients with acute lung injury. Ann Intensive Care. 2013;3(1):25doi: 10.1186/2110-5820-3-25.
Brown, L. M., Calfee, C. S., Howard, J. P., Craig, T. R., Matthay, M. A., & McAuley, D. F. (2013). Comparison of thermodilution measured extravascular lung water with chest radiographic assessment of pulmonary oedema in patients with acute lung injury. Annals of intensive care, 3(1), 25. https://doi.org/10.1186/2110-5820-3-25
Brown, Lisa M, et al. "Comparison of thermodilution measured extravascular lung water with chest radiographic assessment of pulmonary oedema in patients with acute lung injury." Annals of intensive care vol. 3,1 (2013): 25. doi: https://doi.org/10.1186/2110-5820-3-25
Brown LM, Calfee CS, Howard JP, Craig TR, Matthay MA, McAuley DF. Comparison of thermodilution measured extravascular lung water with chest radiographic assessment of pulmonary oedema in patients with acute lung injury. Ann Intensive Care. 2013 Aug 11;3(1):25. doi: 10.1186/2110-5820-3-25. PMID: 23937970; PMCID: PMC3846630.
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Ann Intensive Care. 2013 Aug 11;3(1):25. doi: 10.1186/2110-5820-3-25.

Comparison of thermodilution measured extravascular lung water with chest radiographic assessment of pulmonary oedema in patients with acute lung injury.

Annals of intensive care

Lisa M Brown, Carolyn S Calfee, James P Howard, Thelma R Craig, Michael A Matthay, Daniel F McAuley

Affiliations

  1. Cardiovascular Research Institute, University of California, San Francisco, CA, USA. [email protected].

PMID: 23937970 PMCID: PMC3846630 DOI: 10.1186/2110-5820-3-25

Abstract

BACKGROUND: Acute lung injury and the acute respiratory distress syndrome (ALI/ARDS) are characterized by pulmonary oedema, measured as extravascular lung water (EVLW). The chest radiograph (CXR) can potentially estimate the quantity of lung oedema while the transpulmonary thermodilution method measures the amount of EVLW. This study was designed to determine whether EVLW as estimated by a CXR score predicts EVLW measured by the thermodilution method and whether changes in EVLW by either approach predict mortality in ALI/ARDS.

METHODS: Clinical data were collected within 48 hours of ALI/ARDS diagnosis and daily up to 14 days on 59 patients with ALI/ARDS. Two clinicians scored each CXR for the degree of pulmonary oedema, using a validated method. EVLW indexed to body weight was measured using the single indicator transpulmonary thermodilution technique.

RESULTS: The CXR score had a modest, positive correlation with the EVLWI measurements (r = 0.35, p < 0.001). There was a 1.6 ml/kg increase in EVLWI per 10-point increase in the CXR score (p < 0.001, 95% confidence interval 0.92-2.35). The sensitivity of a high CXR score for predicting a high EVLWI was 93%; similarly the negative predictive value was high at 94%; the specificity (51%) and positive predictive value (50%) were lower. The CXR scores did not predict mortality but the EVLW thermodilution did predict mortality.

CONCLUSION: EVLW measured by CXR was modestly correlated with thermodilution measured EVLW. Unlike CXR findings, transpulmonary thermodilution EVLWI measurements over time predicted mortality in patients with ALI/ARDS.

References

  1. Am J Respir Crit Care Med. 2011 Mar 1;183(5):620-6 - PubMed
  2. Crit Care Med. 2002 Nov;30(11):2450-6 - PubMed
  3. Am Rev Respir Dis. 1992 May;145(5):990-8 - PubMed
  4. Radiology. 2006 Dec;241(3):663-83 - PubMed
  5. J Trauma. 2005 Dec;59(6):1420-3; discussion 1424 - PubMed
  6. Chest. 1983 May;83(5):725-31 - PubMed
  7. Chest. 1985 Nov;88(5):649-52 - PubMed
  8. J Crit Care. 2012 Aug;27(4):376-83 - PubMed
  9. Crit Care Med. 2013 Feb;41(2):472-80 - PubMed
  10. Crit Care. 1999;3(2):R19-R24 - PubMed
  11. J Intensive Care Med. 2003 Sep-Oct;18(5):239-52 - PubMed
  12. J Intensive Care Med. 2003 Jul-Aug;18(4):198-210 - PubMed
  13. Ann Intensive Care. 2012 Jul 5;2 Suppl 1:S15 - PubMed
  14. Intensive Care Med. 1984;10(6):309-13 - PubMed
  15. Crit Care Med. 2008 May;36(5):1412-20 - PubMed
  16. N Engl J Med. 2000 May 4;342(18):1334-49 - PubMed
  17. Crit Care. 2004 Dec;8(6):R451-8 - PubMed
  18. Crit Care Med. 2008 Jan;36(1):69-73 - PubMed
  19. J Clin Invest. 2012 Aug;122(8):2731-40 - PubMed
  20. Br J Radiol. 1981 Apr;54(640):277-88 - PubMed
  21. N Engl J Med. 2002 Apr 25;346(17):1281-6 - PubMed
  22. Crit Care Med. 2006 May;34(5):1437-43 - PubMed
  23. J Trauma. 1982 Dec;22(12):983-8 - PubMed
  24. Crit Care Med. 1983 Jul;11(7):498-501 - PubMed
  25. J Crit Care. 2011 Aug;26(4):402-10 - PubMed
  26. Crit Care Med. 2013 Apr;41(4):990-8 - PubMed
  27. Clin Transplant. 2012 Sep-Oct;26(5):665-71 - PubMed
  28. Crit Care Med. 2008 Jun;36(6):1803-9 - PubMed
  29. Radiol Clin North Am. 1978 Dec;16(3):551-74 - PubMed
  30. Chest. 2004 Mar;125(3):1166; author reply 1167 - PubMed
  31. Chest. 2002 Dec;122(6):2080-6 - PubMed
  32. Am J Respir Crit Care Med. 1994 Mar;149(3 Pt 1):818-24 - PubMed
  33. Crit Care Med. 2009 Jun;37(6):1913-20 - PubMed
  34. Am J Physiol Lung Cell Mol Physiol. 2009 Oct;297(4):L547-58 - PubMed
  35. Med Intensiva. 2012 Oct;36(7):467-74 - PubMed
  36. Am J Respir Crit Care Med. 2006 Feb 1;173(3):281-7 - PubMed
  37. Chest. 2008 Apr;133(4):845-52 - PubMed
  38. Am Rev Respir Dis. 1987 Sep;136(3):662-8 - PubMed
  39. Intensive Care Med. 2013 Jan;39(1):146-50 - PubMed
  40. Intensive Care Med. 2007 Mar;33(3):448-53 - PubMed
  41. Ann N Y Acad Sci. 1982;384:394-410 - PubMed
  42. Crit Care Med. 2004 Jul;32(7):1550-4 - PubMed
  43. Intensive Care Med. 2000 Feb;26(2):180-7 - PubMed
  44. Crit Care Med. 2010 Jan;38(1):114-20 - PubMed
  45. Crit Care. 2012 Jan 03;16(1):R1 - PubMed
  46. Ann Intensive Care. 2012 Jul 05;2(Suppl 1 Diagnosis and management of intra-abdominal hyperten):S1 - PubMed
  47. Crit Care Med. 2005 Aug;33(8):1681-7 - PubMed
  48. Scand J Trauma Resusc Emerg Med. 2011 May 23;19:31 - PubMed
  49. New Horiz. 1993 Nov;1(4):471-7 - PubMed
  50. Br J Anaesth. 2006 Jan;96(1):21-30 - PubMed

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