title: [The prognostic value of extravascular lung water index in critically ill septic shock patients].
abstract: OBJECTIVE
  To investigate the prognostic value of extravascular lung water index (EVLWI) in critically ill patients with septic shock in intensive care unit (ICU).
  
  
  METHODS
  EVLWI was determined by using a PiCCO Monitor, and the daily fluid balance was recorded.
  
  
  RESULTS
  Fifty patients with septic shock were admitted and twenty-six patients survived. The average EVLWI at baseline was 11.7 ml/kg, and the difference was not different between survivors and nonsurvivors, P = 0.551. The EVLWI of day 3 (EVLWI(d3)) in nonsurvivors was significantly higher than the survivors [(14.3 +/- 8.8) ml/kg vs (8.1 +/- 2.7) ml/kg, P = 0.001]. If the patients were divided into three groups by the EVLWI(d3), group one 0-7 ml/kg (4/16), group two 8-14 ml/kg (10/24), and group three > 14 ml/kg (10/10), the hospital mortality of the third group was significantly higher than the other two groups (P = 0.000, 0.002). There was a significant difference between the survivors and the nonsurvivors in the fluid balance at the first day and the following three days (P = 0.000, 0.000). Negative fluid balance was associated with a lower mortality. By using receiver operating characteristic analysis, the area under the curve was 0.740 +/- 0.072 to EVLWI(d3). If EVLWI > 7.5 ml/kg, the sensitivity and the specificity of accurate judgment were 83.3% and 53.8%.
  
  
  CONCLUSIONS
  Dynamic observation of EVLWI can be one of the factors for predicting the prognosis of patients with septic shock. A reduction of EVLWI at early treatment and a negative fluid balance were associated with a better prognosis.
authors.affiliation: Department of Critical Care Medicine, Zhong-Da Hospital and School of Clinical Medicine, Southeast University, Nanjing 210009, China. ycs7415@sohu.com
authors.forename: Cong-shan
authors.initials: CS
authors.lastname: Yang
authors.forename: Hai-bo
authors.initials: HB
authors.lastname: Qiu
authors.forename: Song-qiao
authors.initials: SQ
authors.lastname: Liu
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.forename: Ying-zi
authors.initials: YZ
authors.lastname: Huang
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness; D015633:Extravascular Lung Water / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012772:Shock, Septic / Q000401:mortality / Q000503:physiopathology*; D015996:Survival Rate; D014882:Water-Electrolyte Balance / Q000502:physiology