Inflammatory lung edema correlates with echocardiographic estimation of capillary wedge pressure in newly diagnosed septic patients☆

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Abstract

Purpose:

Lung ultrasound is an accurate and accessible tool to quantify lung edema. Furthermore, left ventricle filling pressures (LVFP) can be assessed with transthoracic echocardiography (TTE) by the E/e′ ratio (E/e′). The present study aimed to assess the correlation between E/e′ and lung edema quantified by a simplified lung ultrasound score (LUS) in newly admitted septic patients.

Materials and methods:

In this prospective observational cohort, septic adult patients admitted at the emergency department of a tertiary hospital were included. LUS consisted of four different patterns of lung edema (from normal aeration to parenchymal consolidation). To compare lung edema with LVFP, E/e′ was calculated immediately before or within 5 min of fluid therapy.

Results:

Fifty patients were enrolled in 3 months. The LUS correlated with E/e′ (r = 0.58, P < 0.0001). The LUS also increased among E/e′ quartiles (Q) (Q1: E/e′ ≤ 4.49; Q2: 4.49 < E/e′ ≤ 5.49; Q3: 5.49 < E/e′ ≤ 7.11; Q4: >7.11; P = 0.0003 for Q1 and 4; 2 and 4); and LUS was significantly higher in abnormal (≥8) vs. normal (<8) values of E/e′ (11.29 vs 8.49, P = 0.007).

Conclusion:

In newly admitted septic patients, lung edema is positively correlated with LVFP prior to fluid therapy. This finding might help find future targets for fluid resuscitation in sepsis.

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