Extravascular lung water in sepsis-associated acute respiratory distress syndrome: Indexing with predicted body weight improves correlation with severity of illness and survival*

Abstract

Increased extravascular lung water is a feature of early acute respiratory distress syndrome and predicts survival. Indexing extravascular lung water to predicted body weight, instead of actual body weight, improves the predictive value of extravascular lung water for survival and correlation with markers of disease severity.

The precision of PiCCO®measurements in hypothermic post‐cardiac arrest patients

“…This result was greater than the reference value (SD) of 7.4 (3.3) ml.kg )1 [17], which suggests an increased risk for pulmonary oedema [33,34]. Moreover, the pulmonary vascular variability index varied from 0.6 to 10.4.…”

“…The detailed principles and the validation of these single-indicator transpulmonary thermodilution-derived variables have been discussed elsewhere [17,[30][31][32]. The extravascular lung water was indexed using predicted body weight [17,33,34].…”

Fluid Management in Acute Lung Injury and ARDS

“…However, the prognostic effect of the quantity of edema fluid, measured by thermodilution, was not found in patients presenting ARDS in this study [5]. Conversely, lung water amount indexed with predicted body weight measured on day 1 of ARDS was found to be predictive of death in another study [6]. By definition, ARDS patients have severe pulmonary edema in the region of 15 to 20 ml.kg -1 of body weight [7,8] and it is probable that other factors, extrapulmonary, will have a more marked prognostic impact.…”

The Acute Stress Reaction to Major Thoracic Surgery

“…It does not cause interstitial edema as long as it can be quantitatively managed by the lymphatic system [13] The transpulmonary thermodilution is an invasive method that allows the estimation of of extravascular lung water (EVLWI) and the extent of capillary leak and fluid overload [55,56]; this technique requires a central venous catheter and a thermistor-tipped arterial thermodilution catheter (Pulsiocath 5F) inserted into the femoral artery and attached to a PiCCOplus® system (Pulsion Medical Systems, Munich, Germany). Therefore this procedure is not feasible in all the surgical and intensive care units.…”