Transpulmonary dilution-derived extravascular lung water as a measure of lung edema.
OBJECTIVE
This review highlights current insights concerning the (measurement of) extravascular lung water as an index of pulmonary edema, by transpulmonary dilution techniques. The focus is on the applicability of the technique at the bedside in monitoring critically ill patients.


RESULTS
Several (animal) studies have been performed to validate the technique by postmortem gravimetry in different conditions. Moreover, recent clinical data emphasize the utility of the thermodilution-derived extravascular lung water, its contribution to the clinical manifestations of acute lung injury/acute respiratory distress syndrome, its response to treatment aimed at edema prevention or resolution, and as a prognostic parameter.


CONCLUSIONS
The thermodilution-derived extravascular lung water is a useful adjunct to assess lung vascular injury, cardiogenic edema and overhydration and to guide treatment in critically ill patients. The effects on morbidity and mortality of this approach need to be studied further.
Khan
Saheed
S
Department of Intensive Care, VU University Medical Center, Amsterdam, The Netherlands.
Trof
Ronald J
RJ
Groeneveld
A B Johan
AB
D000818:Animals; D015633:Extravascular Lung Water; D006801:Humans; D011651:Pulmonary Artery; D011654:Pulmonary Edema / Q000175:diagnosis* / Q000473:pathology; D013815:Thermodilution / Q000379:methods