Clinical Studies of Measuring Extravascular Lung Water by the Thermal Dye Technique in Critically III Patients

Sibbald, William J.; Warshawski, Frank; Short, A.K.; Harris, Jeremy R.; Lefcoe, Michael S.; Holliday, Ronald L.

doi:10.1378/chest.83.5.725

Cited by 82 publications

(31 citation statements)

References 26 publications

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“…The CV for the MDID method in this study was found to be 13%, which is well within the CV range (9.3-17%) reported by Wallin et al using the same method for various conditions in humans and in animals [27]. In the case of the thermo-dye technique, the corresponding CVs have been observed to be <10% [28,29,30].…”

Section: Discussionsupporting

confidence: 89%

Comparison of gravimetric and a double-indicator dilution technique for assessment of extra-vascular lung water in endotoxaemia

et al. 2003

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The molecular double-indicator dilution technique showed similar results as the gravimetrical method for assessment of extra-vascular lung water in non-endotoxaemic conditions. However, during endotoxin-induced lung injury the molecular double indicator dilution technique failed to detect the significant increase in extra-vascular lung water as measured by the gravimetric method. These data suggest that the molecular double indicator dilution technique may be of limited value during sepsis-induced lung injury.

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Section: Discussionsupporting

confidence: 89%

Comparison of gravimetric and a double-indicator dilution technique for assessment of extra-vascular lung water in endotoxaemia

et al. 2003

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“…A total extravascular water content of 420 g was obtained in the case of 5.6 ml kg -1, assuming a body weight of 75 kg. Therefore lung tissue with a weight of 1 kg contains 420 g extravascular water, 380 g additional water and 200 g dry matter, in patients with pulmonary oedema, extravascular lung water increased to 10.2 -4-3.1 ml k g -1 (SIBBALD et al, 1983), which corresponds to a total water content of 85% ~ (765 g + 380 g)/(765 g + 380 g + 200 g)* 100. Critically ill patients showed values of extravascular lung water> 14.3 mlkg -1 (SAKKA et al, 2002), which corresponds to a total water content> 88% ~ (1072.5 g + 380 g)/(1072.5 g + 380 g + 200 g)* 100.…”

Section: Discussionmentioning

confidence: 99%

“…To assess whether such a difference of about 4-5% could be used to classify critical lung oedema, we estimated total lung water content from measurements on patients typically given as extravascular lung water per body weight, in normal patients, 5.6 -4-1.8 ml kg -1 extravascular lung water (SIBBALD et al, 1983) WAS found, which corresponds to about 80% of total lung water (LANCE and SCHUSTER, 1999). A total extravascular water content of 420 g was obtained in the case of 5.6 ml kg -1, assuming a body weight of 75 kg.…”

Section: Discussionmentioning

confidence: 99%

Monitoring water content of rat lung tissuein vivo using microwave reflectometry

Schaefer

Nowak

Kherad

et al. 2004

Med. Biol. Eng. Comput.

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Measurement of lung water is an important diagnostic means of assessing pulmonary oedema. Water content affects the dielectric spectrum at microwave frequencies, but quantification is still a problem. A new lung tissue model is presented that allows the calculation of water content from dielectric permittivity. The dielectric permittivity of lung tissue was measured by microwave reflectometry using a non-invasive surface probe. During perfusion of rat lungs (n = 22) with blood, injury was induced by interruption of the blood supply for a duration between 0 (control) and 2 h. Water content was assessed from dielectric permittivity using a new mixture formula and was also determined by drying and weighing. The mixture formula allows for the dielectric polarisation of water, dry matter and air in the tissue. A linear correlation was found between total water content determined from dielectric permittivity and that from drying and weighing (y= 1.001x, R2 = 0.8). Lung injury showed an increase in total water content from 80.9 +/- 1.2% (control) to 84.1 +/- 0.9% (p < 0.01). The analysis of dielectric permittivity data at microwave frequencies with the new tissue model is sensitive enough to detect water accumulation produced by lung injury and it can be used to monitor total water content without tissue destruction.

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“…A double indicator dilution technique using heat (diffusible indicator) and sodium chloride (nondiffusible indicator, by definition) currently is used to obtain a quantitative parameter called the lung thermal volume (LTV). [1][2][3][4][5][6][7][8][9] This technique measures Received August 26, 1992, revision accepted October 12, 1992. For reprints contact: Masumi Nawada, M.D., Second Department of Internal Medicine, Gifu University School of Medicine, Tsukasa-machi 40, Gifu City, Gifu 500, JAPAN.…”

Section: Introductionmentioning

confidence: 99%

Extravascular lung water measured with99mTc-RBC and99mTc-DTPA is increased in left-sided heart failure

et al. 1993

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Extravascular lung water (EVLW) was quantitatively measured in 81 patients consisting of 10 subjects with normal cardiac function and 71 patients with left-sided heart diseases, using 99mTc-RBC as a non-diffusible indicator and 99mTc-DTPA as a diffusible indicator in the equilibrium phase. EVLW averaged 3.0 +/- 1.4 (ml/kg, mean +/- SD) in subjects with normal cardiac function (n = 10), 4.3 +/- 1.7 in New York Heart Association functional class I patients (n = 30), 4.8 +/- 2.4 in NYHA functional class II patients (n = 33) and 9.4 +/- 5.4 in NYHA functional class III (n = 8) patients. EVLW was greater in NYHA class III than in normal controls or NYHA classes I or II (p < 0.01). Lung thermal volume (LTV) was also measured in 31 of the 81 patients using a double indicator dilution technique with sodium and heat. LTV averaged 6.0 +/- 1.2 (ml/kg) in normal subjects (n = 4), 8.6 +/- 2.0 in NYHA functional class I patients (n = 11), 9.7 +/- 3.0 in NYHA functional class II patients (n = 13), and 15.9 +/- 8.2 in NYHA functional class III patients (n = 3). The correlation between EVLW and LTV was significant (EVLW = 0.79 x LTV - 72.8, r = 0.80, p < 0.01). There were significant differences in EVLW/LTV ratio between NYHA class III (0.93 +/- 0.16) and NYHA class I (0.62 +/- 0.22). Thus, it was shown that EVLW was increased in left-sided heart failure and that LTV overestimated the EVLW.

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Clinical Studies of Measuring Extravascular Lung Water by the Thermal Dye Technique in Critically III Patients

Cited by 82 publications

References 26 publications

Comparison of gravimetric and a double-indicator dilution technique for assessment of extra-vascular lung water in endotoxaemia

Comparison of gravimetric and a double-indicator dilution technique for assessment of extra-vascular lung water in endotoxaemia

Monitoring water content of rat lung tissuein vivo using microwave reflectometry

Extravascular lung water measured with99mTc-RBC and99mTc-DTPA is increased in left-sided heart failure

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