Small Increases in Extravascular Lung Water Are Accurately Detected by Transpulmonary Thermodilution

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Abstract

Background:

Detection of small (10–20%) increases in lung water may be relevant to detect incipient pulmonary edema but no clinically usable method has demonstrated this capability to date.

Methods:

In six pigs weighing 28 to 35 kg, we performed 18 determinations of extravascular lung water (EVLW; transpulmonary thermodilution method) before and immediately after the intratracheal introduction of 50 mL of saline solution. Six determinations were performed in normal lung and 12 in edematous lung.

Results:

In normal lung, the mean of EVLW increased from 245 ± 18 mL to 288 ± 19 mL (p < 0.001) after the intratracheal introduction of 50 mL of saline solution; therefore, 43 of the 50 mL (84%) were detected (range, 37–48 mL). In edematous lung, the EVLW increased from 491 ± 106 mL to 530 ± 108 mL after the introduction of 50 mL of saline solution; therefore, 39 of the 50 mL (77%) were detected (range, 15–67 mL).

Conclusion:

The transpulmonary thermodilution technique accurately detects small increases in extravascular lung water and may permit accurate diagnosis of incipient pulmonary edema.

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