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Intravascular volume monitoring and extravascular lung water in septic patients with pulmonary edema.
- Source :
-
Intensive care medicine [Intensive Care Med] 2002 Jun; Vol. 28 (6), pp. 712-8. Date of Electronic Publication: 2002 May 18. - Publication Year :
- 2002
-
Abstract
- Objective: To evaluate whether different indicators using for guiding volume expansion are valuable tools to assess edematous lung injury in patients with septic shock.<br />Design and Setting: Prospective observational clinical study in a university intensive care unit.<br />Patients: Sixteen consecutive mechanically ventilated patients developing septic shock with evidence of pulmonary edema on chest radiograph and severe hypoxemia (PaO(2)/FIO(2) <250 mmHg).<br />Measurements and Results: A pulmonary artery catheter was used for the measurement of cardiac index (CI), central venous pressure (CVP), and pulmonary artery occlusion pressure (PAOP). A fiberoptic catheter was placed in the descending aorta. Measurements of extravascular lung water index (EVLWI), intrathoracic blood volume index (ITBVI), and total end-diastolic volume index (TEDVI) were obtained using the thermal dye dilution technique. Measurements were taken just after placement of catheters and 24 h later. Fluid balance was also estimated within the first 24 h. TEDVI and ITBVI were significantly correlated with EVLWI, but not CVP and PAOP. Analysis of 24-h changes showed that the changes in TEDVI and in ITBVI reflected the change in EVLWI, whereas PAOP, CVP, and fluid balance did not.<br />Conclusions: Volume variables (TEDVI, ITBVI) are more useful indicators than pressure variables (CVP, PAOP) for assessment of EVLWI in septic patients with pulmonary edema.
Details
- Language :
- English
- ISSN :
- 0342-4642
- Volume :
- 28
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Intensive care medicine
- Publication Type :
- Academic Journal
- Accession number :
- 12107676
- Full Text :
- https://doi.org/10.1007/s00134-002-1286-6