Articles: extravascular-lung-water.
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Critical care medicine · Feb 2013
Extravascular lung water is an independent prognostic factor in patients with acute respiratory distress syndrome.
Acute respiratory distress syndrome might be associated with an increase in extravascular lung water index and pulmonary vascular permeability index, which can be measured by transpulmonary thermodilution. We tested whether extravascular lung water index and pulmonary vascular permeability index are independent prognostic factors in patients with acute respiratory distress syndrome. ⋯ Extravascular lung water index and pulmonary vascular permeability index measured by transpulmonary thermodilution are independent risk factors of day-28 mortality in patients with acute respiratory distress syndrome.
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Editorial Comment
Extravascular lung water and the pulmonary vascular permeability index may improve the definition of ARDS.
The recent Berlin definition has made some improvements in the older definition of acute respiratory distress syndrome (ARDS), although the concepts and components of the definition remained largely unchanged. In an effort to improve both predictive and face validity, the Berlin panel has examined a number of additional measures that may reflect increased pulmonary vascular permeability, including extravascular lung water. ⋯ By using extravascular lung water and the pulmonary vascular permeability index, both of which are derived from transpulmonary thermodilution, the authors could successfully differentiate between patients with ARDS and other patients in respiratory failure due to either cardiogenic edema or pleural effusion with atelectasis. This commentary discusses the merits and limitations of this study in view of the potential improvement that transpulmonary thermodilution may bring to the definition of ARDS.
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Zhonghua Wei Zhong Bing Ji Jiu Yi Xue · Jan 2013
[Clinical value of extravascular lung water and preload parameters in weaning of mechanical ventilation in patients with septic shock].
To investigate the values of extravascular lung water and preload parameters of weaning from mechanical ventilation on patients with septic shock. ⋯ Increased EVLW is the reason of pulmonary edema caused by weaning in septic shock patients, to which both hydrostatic and pulmonary permeability may contribute, and the latter could be more important. Monitoring preload parameters could help distinguish the mechanism of pulmonary edema after weaning, which may be useful in treatment.