Articles: extravascular-lung-water.
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Critical care medicine · Mar 2012
Comparative StudyExtravascular lung water predicts progression to acute lung injury in patients with increased risk*.
To compare the extravascular lung water index and other markers of disease severity in patients with acute lung injury vs. patients at risk for development of acute lung injury and to determine their ability to predict progression to acute lung injury in patients at risk. ⋯ Elevated extravascular lung water index is a feature of early acute lung injury and discriminates between those with acute lung injury and those without. Furthermore, extravascular lung water index predicts progression to acute lung injury in patients with risk factors for development of acute lung injury 2.6 ± 0.3 days before the patients meet American European Consensus Committee criteria for it. These 2.6 ± 0.3 days may then represent missed opportunity for therapeutic intervention and improved outcome.
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Critical care medicine · Mar 2012
Editorial CommentA new and simple definition for acute lung injury*.
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The diagnosis of acute lung injury (ALI) may be more robust if more accurate physiological markers can be identified. Extravascular lung water (EVLW) is one possible marker, and it has been shown to correlate with respiratory function and mortality in patients with sepsis. Whether EVLW confers diagnostic value in a general population with shock, as well as which index performs best, is unclear. We investigated the diagnostic accuracy of various EVLW indices in patients with shock. ⋯ EVLW was associated with degree of lung injury and mortality, regardless of the index used, confirming that it may be used as a bedside indicator of disease severity. The use of EVLW as a bedside test conferred added diagnostic value for the identification of patients with lung injury.
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Annals of intensive care · Jan 2012
Fluid management in critically ill patients: the role of extravascular lung water, abdominal hypertension, capillary leak, and fluid balance.
Capillary leak in critically ill patients leads to interstitial edema. Fluid overload is independently associated with poor prognosis. Bedside measurement of intra-abdominal pressure (IAP), extravascular lung water index (EVLWI), fluid balance, and capillary leak index (CLI) may provide a valuable prognostic tool in mechanically ventilated patients. ⋯ There seems to be an important correlation between CLI, EVLWI kinetics, IAP, and fluid balance in mechanically ventilated patients, associated with organ dysfunction and poor prognosis. In this context, we introduce the global increased permeability syndrome.
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Multicenter Study Observational Study
The clinical usefulness of extravascular lung water and pulmonary vascular permeability index to diagnose and characterize pulmonary edema: a prospective multicenter study on the quantitative differential diagnostic definition for acute lung injury/acute respiratory distress syndrome.
Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is characterized by features other than increased pulmonary vascular permeability. Pulmonary vascular permeability combined with increased extravascular lung water content has been considered a quantitative diagnostic criterion of ALI/ARDS. This prospective, multi-institutional, observational study aimed to clarify the clinical pathophysiological features of ALI/ARDS and establish its quantitative diagnostic criteria. ⋯ PVPI may be a useful quantitative diagnostic tool for ARDS in patients with hypoxemic respiratory failure and radiographic infiltrates.