Back to Search
Start Over
Echocardiography to predict tolerance to negative fluid balance in acute respiratory distress syndrome/acute lung injury
- Source :
- Journal of Critical Care. 28:1006-1010
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- Purpose In acute respiratory distress syndrome (ARDS) and acute lung injury (ALI), a conservative fluid management strategy improves lung function but could jeopardize extrapulmonary organ perfusion. The objective was to evaluate the diagnostic accuracy of echocardiography to predict tolerance of negative fluid balance (NFB) in patients with ARDS/ALI. Materials and Methods A prospective and observational study in an adult intensive care unit of a university hospital was conducted. All hemodynamically stable patients with ARDS/ALI were included. Echocardiography was performed before NFB and again after 24 hours. Tolerance of NFB was evaluated by the presence of hypotension, acute kidney injury, or need for fluid expansion. The 2 patient groups (tolerating and not tolerating NFB) were compared. Results Forty-five patients were included. Median age (Q1-Q3) was 58 (52-66) years, and the ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen was 205 (163-258) mm Hg. Negative fluid balance was 1950 (1200-2200) mL within 24 hours in the tolerant group. Complications of NFB were observed in 35% cases. After univariate and multivariate logistic regression analyzes, 2 criteria was independently associates with poor tolerance: mitral inflow E wave to early diastolic mitral annulus velocities ratio (E/Ea ratio; odds ratio, 2.02 [1.02-4.02]; P = .04) and weight gain (odds ratio, 1.2 [1.03-1.4]; P = .02). The area under receiver operating characteristic curves was 0.74 for E/Ea and 0.77 for weight gain. Conclusions The ratio of E/Ea accurately predicted tolerance of NFB in patients with ARDS/ALI.
- Subjects :
- Male
ARDS
Acute Lung Injury
Lung injury
Critical Care and Intensive Care Medicine
Inferior vena cava
Predictive Value of Tests
Fraction of inspired oxygen
medicine
Humans
Prospective Studies
Pulmonary wedge pressure
APACHE
Aged
Respiratory Distress Syndrome
business.industry
Acute kidney injury
Odds ratio
Middle Aged
Water-Electrolyte Balance
medicine.disease
Respiratory Function Tests
Intensive Care Units
medicine.vein
Echocardiography
Anesthesia
Female
business
Fluid balance
Subjects
Details
- ISSN :
- 08839441
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Journal of Critical Care
- Accession number :
- edsair.doi.dedup.....736c056596f186c4941e0d576f6dea19