Transthoracic bioimpedance can measure extravascular lung water in acute lung injury.
We used a porcine endotoxemic model of acute lung injury to compare extravascular lung water (EVLW) measured by right transthoracic bioimpedance to postmortem gravimetric EVLW measurements. Adult pigs were randomized into control (N = 5) or endotoxin groups [150 microgram/kg Escherichia coli lipopolysaccharide B for 1 hr followed by 3 hr of resuscitation for a thermodilution cardiac output less than 90% of baseline using either isotonic saline (N = 5) or isooncotic albumin (N = 5)]. Right lung resistance was measured using a novel electrode array and a highly sensitive analyzer and was used to calculate right lung resistivity. At the end of the experiment, animals in the endotoxin-albumin group had higher gravimetric EVLWs than those in the endotoxin-saline or control groups (P < 0.05). Right lung resistivity corrected for body weight significantly correlated with gravimetric EVLW (r2 = 0.49; SEE = 0.96; P = 0.0038). Using multiple regression analysis, a predictive equation for EVLW based on right lung resistivity, body weight, and mean pulmonary artery pressure was generated (r2 = 0.81; SEE = 0.60; P < 0.0001). These results demonstrate that right lung resistivity measurements can provide a noninvasive estimate of EVLW. In addition, crystalloid may be preferable to colloid for fluid resuscitation in noncardiogenic pulmonary edema.
Nierman
D M
DM
Department of Medicine, The Mount Sinai Medical Center, New York, New York 10029-6574, USA.
Eisen
D I
DI
Fein
E D
ED
Hannon
E
E
Mechanick
J I
JI
Benjamin
E
E
D000818:Animals; D001823:Body Composition / Q000502:physiology; D017097:Electric Impedance; D004594:Electrophysiology / Q000295:instrumentation; D015633:Extravascular Lung Water / Q000378:metabolism*; D005260:Female; D006400:Hematocrit; D006439:Hemodynamics / Q000502:physiology; D008168:Lung / Q000378:metabolism* / Q000473:pathology; D008171:Lung Diseases / Q000378:metabolism*; D009929:Organ Size; D010100:Oxygen / Q000097:blood; D011652:Pulmonary Circulation; D011654:Pulmonary Edema / Q000139:chemically induced / Q000378:metabolism*; D012044:Regression Analysis; D012151:Resuscitation
D010100:Oxygen