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

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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.HighlightsPoint of care ultrasound is sensitive to identify lung edema in recently admitted septic patients.Point of care ultrasound can be used to assess diastolic dysfunction in septic patients.Lung edema correlates positively with LVFP even before fluid therapy.Point of care ultrasound is a promising tool to guide fluid management.

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