title: Comparison of gravimetric and a double-indicator dilution technique for assessment of extra-vascular lung water in endotoxaemia.
abstract: OBJECTIVE
  To compare a molecular double-indicator dilution technique with the gravimetrical reference method for measurement of extra-vascular lung water in porcine endotoxin shock.
  
  
  METHODS
  Open comparative experimental study.
  
  
  METHODS
  Animal research laboratory.
  
  
  RESULTS
  In fourteen anaesthetised, mechanically ventilated landrace pigs, central and pulmonary haemodynamics as well as pulmonary gas exchange were measured. Extra-vascular lung water was quantitated gravimetrically as well as with a molecular double indicator dilution technique. Eight of these animals were subjected to endotoxaemia, the rest serving as sham controls. No difference in extra-vascular lung water was observed between the two methods in sham animals. Furthermore, extra-vascular lung water assessed with the molecular double-indicator dilution technique at the initiation of endotoxin infusion did not differ significantly from the corresponding values for sham animals. Endotoxaemia induced a hypodynamic shock with concurrent pulmonary hypertension and a pronounced deterioration in gas exchange. No increase in extra-vascular lung water was detected with the molecular double-indicator dilution technique in response to endotoxin, whereas this parameter was significantly higher when assessed with the gravimetric method.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgical Sciences, Section of Anaesthesiology & Intensive Care Medicine, Karolinska Institute, 17176 Stockholm, Sweden. patrik.rossi@.ks.se
authors.forename: P
authors.initials: P
authors.lastname: Rossi
authors.forename: A
authors.initials: A
authors.lastname: Oldner
authors.forename: M
authors.initials: M
authors.lastname: Wanecek
authors.forename: L G
authors.initials: LG
authors.lastname: Leksell
authors.forename: A
authors.initials: A
authors.lastname: Rudehill
authors.forename: D
authors.initials: D
authors.lastname: Konrad
authors.forename: E
authors.initials: E
authors.lastname: Weitzberg
mesh_terms: D000818:Animals; D019446:Endotoxemia / Q000503:physiopathology*; D015633:Extravascular Lung Water / Q000378:metabolism*; D006439:Hemodynamics / Q000502:physiology; D007201:Indicator Dilution Techniques; D008070:Lipopolysaccharides / Q000633:toxicity; D011659:Pulmonary Gas Exchange; D018709:Statistics, Nonparametric; D013552:Swine
chemical_list: D008070:Lipopolysaccharides