TY - JOUR
T1 - Global end-diastolic volume is an important contributor to increased extravascular lung water in patients with acute lung injury and acuterespiratory distress syndrome
T2 - A multicenter observational study
AU - on behalf of the PiCCO Pulmonary Edema Study Group
AU - Kaneko, Tadashi
AU - Kawamura, Yoshikatsu
AU - Maekawa, Tsuyoshi
AU - Tagami, Takashi
AU - Nakamura, Toshiaki
AU - Saito, Nobuyuki
AU - Kitazawa, Yasuhide
AU - Ishikura, Hiroyasu
AU - Sugita, Manabu
AU - Okuchi, Kazuo
AU - Rinka, Hiroshi
AU - Watanabe, Akihiro
AU - Kase, Yoichi
AU - Kushimoto, Shigeki
AU - Izumino, Hiroo
AU - Kanemura, Takashi
AU - Yoshikawa, Kazuhide
AU - Takahashi, Hiroyuki
AU - Irahara, Takayuki
AU - Sakamoto, Teruo
AU - Kuroki, Yuichi
AU - Taira, Yasuhiko
AU - Seo, Ryutarou
AU - Yamaguchi, Junko
AU - Takatori, Makoto
N1 - Publisher Copyright:
© 2014 Kaneko et al.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2014/4/1
Y1 - 2014/4/1
N2 - Background: Extravascular lung water (EVLW), as measured by the thermodilution method, reflects the extent of pulmonary edema. Currently, there are no clinically effective treatments for preventing increases in pulmonary vascular permeability, a hallmark of lung pathophysiology, in patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS). In this study, we examined the contributions of hemodynamic and osmolarity factors, for which appropriate interventions are expected in critical care, to EVLW in patients with ALI/ARDS.Methods: We performed a subgroup analysis of a multicenter observational study of patients with acute pulmonary edema. Overall, 207 patients with ALI/ARDS were enrolled in the study. Multivariate regression analysis was used to evaluate the associations of hemodynamic and serum osmolarity parameters with the EVLW index (EVLWI; calculated as EVLW/Ideal body weight). We analyzed factors measured on the day of enrollment (day 0), and on days 1 and 2 after enrollment.Results: Multivariate regression analysis showed that global end-diastolic volume index (GEDVI) was significantly associated with EVLWI measured on days 0, 1, and 2 (P = 0.002, P < 0.001, and P = 0.003, respectively), whereas other factors were not significantly associated with EVLWI measured on all 3 days.Conclusions: Among several hemodynamic and serum osmolarity factors that could be targets for appropriate intervention, GEDVI appears to be a key contributor to EVLWI in patients with ALI/ARDS.
AB - Background: Extravascular lung water (EVLW), as measured by the thermodilution method, reflects the extent of pulmonary edema. Currently, there are no clinically effective treatments for preventing increases in pulmonary vascular permeability, a hallmark of lung pathophysiology, in patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS). In this study, we examined the contributions of hemodynamic and osmolarity factors, for which appropriate interventions are expected in critical care, to EVLW in patients with ALI/ARDS.Methods: We performed a subgroup analysis of a multicenter observational study of patients with acute pulmonary edema. Overall, 207 patients with ALI/ARDS were enrolled in the study. Multivariate regression analysis was used to evaluate the associations of hemodynamic and serum osmolarity parameters with the EVLW index (EVLWI; calculated as EVLW/Ideal body weight). We analyzed factors measured on the day of enrollment (day 0), and on days 1 and 2 after enrollment.Results: Multivariate regression analysis showed that global end-diastolic volume index (GEDVI) was significantly associated with EVLWI measured on days 0, 1, and 2 (P = 0.002, P < 0.001, and P = 0.003, respectively), whereas other factors were not significantly associated with EVLWI measured on all 3 days.Conclusions: Among several hemodynamic and serum osmolarity factors that could be targets for appropriate intervention, GEDVI appears to be a key contributor to EVLWI in patients with ALI/ARDS.
KW - Acute lung injury
KW - Acute respiratory distress syndrome
KW - Extravascular lung water
KW - Global end-diastolic volume
KW - Multivariate regression analysis
KW - Pulmonary edema
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U2 - 10.1186/2052-0492-2-25_25
DO - 10.1186/2052-0492-2-25_25
M3 - Article
AN - SCOPUS:84979195120
VL - 2
JO - Journal of Intensive Care
JF - Journal of Intensive Care
SN - 2052-0492
IS - 1
M1 - 25
ER -