How important is the measurement of extravascular lung water?

Current Opinion in Critical Care

Volumn 13, Issue 1, 2007, Pages 79-83

  Fernández Mondéjar, Enrique ^a,b   Guerrero López, Francisco ^a   Colmenero, Manuel ^a  

^a HOSPITAL UNIVERSITARIO VIRGEN DE LAS NIEVES   (Spain)

^b Pulsion Medical Systems   (Germany)

Author keywords

Acute lung injury; Acute respiratory distress syndrome; Extravascular lung water; Monitoring; Pulmonary edema

Indexed keywords

ACCURACY; ACUTE LUNG INJURY; ADULT RESPIRATORY DISTRESS SYNDROME; ARTERIAL OXYGEN SATURATION; ARTIFICIAL VENTILATION; COMPUTER ASSISTED TOMOGRAPHY; DIAGNOSTIC ACCURACY; DIAGNOSTIC IMAGING; FLUID BALANCE; FLUID THERAPY; FOLLOW UP; GRAVIMETRY; HEART OUTPUT; HEMODYNAMICS; HUMAN; INTERMETHOD COMPARISON; LUNG EDEMA; LUNG EXTRAVASCULAR FLUID; LUNG FUNCTION; LUNG INJURY; LUNG INSUFFICIENCY; MORTALITY; OBSERVER VARIATION; OXYGENATION; PATIENT MONITORING; PROGNOSIS; RELIABILITY; REVIEW; SEPSIS; THERMODILUTION; THORAX RADIOGRAPHY;

ACUTE DISEASE; CRITICAL CARE; EXTRAVASCULAR LUNG WATER; FLUID THERAPY; HUMANS; PROGNOSIS; PULMONARY EDEMA; RESPIRATORY DISTRESS SYNDROME, ADULT; SEVERITY OF ILLNESS INDEX; SICKNESS IMPACT PROFILE;

EID: 33845974122     PISSN: 10705295     EISSN: 15317072     Source Type: Journal    
DOI: 10.1097/MCC.0b013e328011459b     Document Type: Review

References (35)

1. Sakka SG, Ruhl CC, Pfeiffer UJ, et al. Assessment of cardiac preload and extravascular lung water by single transpulmonary thermodilution. Intensive Care Med 2000; 26:180-187.
2. Lewis FR, Elings VB, Hill SL, et al. The measurement of extravascular lung water by thermal-green dye indicator dilution. Ann NY Acad Sci 1982; 384:393-410.
3. Saul GM, Feeley TW, Mihn FG. Effect of graded administration of PEEP on lung water in non cardiogenic pulmonary edema. Crit Care Med 1982; 10:667-669.
4. Mihn FG, Feeley TW, Rosenthal MH, et al. Measurement of extravascular lung water in dogs using the thermal-green dye indicator dilution method. Anesthesiology 1982; 57:116-122.
5. Colmenero-Ruiz M, Fernández-Mondéjar E, Fernández Sacristán MA, et al. PEEP and low tidal volume reduces extravascular lung water in porcine pulmonary edema. Am J Respir Crit Care Med 1997; 155:964-970.
6. Patroniti N, Bellani G, Maggioni E, et al. Measurement of pulmonary edema in patients with acute respiratory distress syndrome. Crit Care Med 2005; 33:2547-2554. The authors present one of the few clinical studies analyzing the accuracy of extravascular lung water measurements. In 14 ARDS patients, extravascular lung water measured by double indicator (indocyanine green, cold) was closely correlated with estimations based on spiral chest CT.
7. Katzenelson R, Perel A, Berkenstadt H, et al. Accuracy of transpulmonary thermodilution versus gravimetric measurement of extravascular lung water. Crit Care Med 2004; 32:1550-1554.
8. Kirov M, Kuzkov VV, Kuklin VN. Extravascular lung water assessed by transpulmonary single thermodilution and postmortem gravimetry in sheep. Crit Care 2004; 8:R451-R458.
9. Rossi P, Wanecek M, Rudehill A, et al. Comparison of a single indicator and gravimetric technique for estimation of extravascular lung water in endotoxemic pigs. Crit Care Med 2006; 34:1437-1443.
10. Fernández-Mondéjar E, Rivera-Fernández R, García-Delgado M, et al. Small increases in extravascular lung water are accurately detected by transpulmonary thermodilution. J Trauma 2005; 59:1420-1424.
11. Fernández-Mondéjar E, Castaño-Pérez J, Rivera-Fernández R, et al. Quantification of lung water by transpulmonary thermodilution in normal and edematous lung. J Crit Care 2003; 18:253-258.
12. Snashall PD, Suzanne JK, Morgan BM, et al. The radiographic detection of acute pulmonary edema. A comparison of radiographic appearances, densitometry and lung water in dogs. Br J Radiol 1981; 54:277-288.
13. Bongard FS, Matthay MA, Mckersei RC, et al. Morphologic and physiologic correlates of increased extravascular lung water. Surgery 1984; 96:395-403.
14. Rubenfeld GD, Caldwell E, Granton J, et al. Interobserver variability in applying a radiograph definition for ARDS. Chest 1999; 116:1347-1353.
15. Helperin BD, Feeley TW, Mihn FG, et al. Evaluation of the portable chest roentgenogram for quantitating extravascular lung water in critically ill adults. Chest 1985; 88:649-652.
16. Scillia P, Delcroix M, Lejeune P, et al. Hydrostatic pulmonary edema: evaluation with thin-section CT in dogs. Radiology 1999; 211:161-168.
17. Shah MR, Hasselblad V, Stevenson LW, et al. Impact of pulmonary artery catheter in critically ill patients. Meta-analysis of randomized clinical trials. JAMA 2005; 294:1664-1670. This describes a meta-analysis of 13 randomized clinical trials. Use of pulmonary artery catheter as a guide for fluid and vasoactive management does not influence mortality or ICU stay.
18. Vincent JL, Gerlach H. Fluid resuscitation in severe sepsis and septic shock: An evidence-based review. Crit Care Med 2004; 32 (Suppl):S451-S454.
19. The National Heart, Lung and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trial Network.Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 2006; 354:2564-2575. This randomized study in 1000 patients with acute lung failure compared two fluid management strategies: liberal (similar to the current standard guide line in most centers) versus conservative. Liberally managed patients received more fluids and less furosemide than did those under conservative management. Although there were no differences in the 60-day mortality, lung function and duration of mechanical ventilation were significantly better in the conservative group, therefore this strategy is recommended.
20. Sakr Y, Vincent JL, Reinhart K, et al. High tidal volume and positive fluid balance are associated with worse outcome in acute lung injury. Chest 2005; 128:3098-3108.
21. Martin GS, Moss M, Wheeler AP, et al. A randomized controlled trial of furosemide with or without albumin in hypoproteinemic patients with acute lung injury. Crit Care Med 2005; 33:1681-1687. A randomized, double-blinded trial compared furosemide plus albumin with furosemide plus placebo in hypoproteinemic patients with acute lung injury. Albumin-treated patients had better oxygenation, better hemodynamic stability, and a more negative fluid balance.
22. Eisemberg PR, Hansbrough JR, Anderson D, Schuster DP. A prospective study on lung water measurement during patient management in an intensive care unit. Am Rev Respir Dis 1987; 136:662-668.
23. Mitchel JP, Schuller D, Calandrino FS, et al. Improved outcome based on fluid management in critically ill patients requiring pulmonary artery catheterization. Am Rev Respir Dis 1992; 145:990-998.
24. Michard F, Zarka V, Alaya S. Better characterization of acute lung injury/ARDS using lung water. Chest 2004; 125:1166.
25. Martin GS, Eaton S, Mealer M, et al. Extravascular lung water in patients with severe sepsis: a prospective cohort study. Crit Care 2005; 9:R74-R82.
26. Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory distress in adults. Lancet 1967; 2:319-323.
27. Murray JF, Mathay Ma, Luce JM, Flick MR. An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis 1988; 138:720-723.
28. Bernard GR, Artigas A, Brigham KL, et al. The American-European Consensus Conference on ARDS. Definition mechanisms, relevant outcomes, and clinical trial coordination. Am J Resp Crit Care Med 1994; 149:818-824.
29. Peñuelas O, Esteban A, Frutos-Vivar F, et al. Validez de los criterios diagnósticos del síndrome de distrés respiratorio agudo. Med Intensiva 2006; 30:212-217. This is an excellent review of the validity of different diagnostic criteria for acute respiratory distress syndrome.
30. Esteban A, Fernández-Segoviano P, Frutos-Vivar F, et al. Comparison of clinical criteria for the acute respiratory distress syndrome with autopsy findings. Ann Intern Med 2004; 141:440-445.
31. Gattinoni L, Pelosi P, Suter PM, et al. Acute respiratory distress syndrome caused by pulmonary and extrapulmonary disease. Different syndromes? Am J Respir Crit Care Med 1998; 158:3-11.
32. Shuster DP. Identifying patients with ARDS: time for a different approach. Intensive Care Med 1977; 23:1197-1203.
33. Shuster DP, Stark T, Stephenson J, et al. Detecting lung injury in patients with pulmonary edema. Intensive Care Med 2002; 28:1246-1253.
34. Sakka SG, Klein M, Reinhart K, et al. Prognostic value of extravascular lung water in critically ill patients. Chest 2002; 122:2080-2086.
35. Kuzkov V, Kirov M, Sovershaev MA, et al. Extravascular lung water determined with single transpulmonary thermodilution correlates with severity of sepsis-induced acute lung injury. Crit Care Med 2006; 34:1647-1653.