Fluid challenge in patients at risk for fluid loading‐induced pulmonary edema

Abstract

In this selected group of at-risk patients, the optimization of cardiac output guided by the concept of best individual filling pressure/stroke volume relationship did not worsen permeability pulmonary edema.

Inferior Vena Cava Diameter Correlates with Invasive Hemodynamic Measures in Mechanically Ventilated Intensive Care Unit Patients with Sepsis

“…It is therefore not surprising that increased extravascular lung water has been demonstrated to denote an adverse prognosis in septic patients (4,17). In addition, a strong correlation between extravascular lung water and the PaO 2 /FiO 2 ratio has been shown previously.…”

Extravascular lung water after pneumonectomy and one-lung ventilation in sheep

“…We calculated the true relationship between ITBVI and GEDVI by using their directly measured values as determined with TDD. In addition, pulmonary vascular permeability indexes were calculated as PVPI PBV ϭ EVLWI TDD /PBVI TDD and PVPI ITBV ϭ EVLWI TDD /ITBVI TDD (12,13). Appendix 1 illustrates the methodology of the TDD and the STD techniques.…”

Lung Water—The Pool of Evidence Deepens*

“…From this study and others we now know that EVLWi is sensitive marker of disease severity, can predict outcome in both sepsis and ARDS, can predict progression to ARDS in patients at risk, may be useful as a sensitive preload metric in sepsis and ARDS (15)(16)(17)(18), and may improve outcome when incorporated in a resuscitative strategy (7,8). Given this, and as we learn more about the importance of more precise resuscitation/deresuscitation, the deleterious effects of both under and over resuscitation, positive fluid balance, and the benefit of less aggressive positive pressure ventilation, the use of EVLWi to guide therapeutic effort, especially in ARDS, takes on more appeal.…”