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

摘要

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 p 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 .