title: Extravascular lung water correlates multiorgan dysfunction syndrome and mortality in sepsis.
abstract: BACKGROUND
  This study was designated to investigate whether increased extravascular lung water index (EVLWI) may correlate multiple organ dysfunction syndrome (MODS) and mortality in sepsis.
  
  
  METHODS
  We designed a prospective cohort study in an intensive care unit of a tertiary care hospital. Sixty-seven patients with severe sepsis were included. Data were used to determine an association between EVLWI and the development of MODS and mortality. These connections were determined by the multiple logistic regression, plotting the receiver operating characteristic (ROC) curve and by Spearman test.
  
  
  RESULTS
  EVLWI levels were higher in MODS patients on day 1 (median (IQR), 18(12.8-23.9) ml/kg, n = 38, p<0.0001) than in those without (median (IQR), 12.4 (7.9-16.3) ml/kg, n = 29) and day 3 (median (IQR), 17.8 (11.2-22.8) ml/kg, n = 29, p = 0.004) than in those without (median (IQR), 12.4 (8.0-16.3) ml/kg, n = 29). EVLWI was used as an independent predictor of the development of MODS (odds ratio, 1.6; p = 0.005; 95% confidence interval, 1.2∼2.2) during ICU stay. The area under the ROC curve showed that EVLWI levels could predict MODS (0.866) and mortality (0.881) during ICU stay. Meanwhile, the higher of SOFA score, the more EVLWI was found on day 1 (r = 0.7041, p<0.0001) and day 3 (r = 0.7732, p<0.0001).
  
  
  CONCLUSIONS
  Increased EVLWI levels correlates development of MODS and mortality during the patients' ICU stay. Further more, the potential of novel treatment in severe sepsis with lung injury may develop.
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei, Taiwan, Republic of China.
authors.forename: Fu-Tsai
authors.initials: FT
authors.lastname: Chung
authors.forename: Horng-Chyuan
authors.initials: HC
authors.lastname: Lin
authors.forename: Chih-Hsi
authors.initials: CH
authors.lastname: Kuo
authors.forename: Chih-Teng
authors.initials: CT
authors.lastname: Yu
authors.forename: Chun-Liang
authors.initials: CL
authors.lastname: Chou
authors.forename: Kang-Yun
authors.initials: KY
authors.lastname: Lee
authors.forename: Han-Pin
authors.initials: HP
authors.lastname: Kuo
authors.forename: Shu-Min
authors.initials: SM
authors.lastname: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods; D015633:Extravascular Lung Water; D005260:Female; D006801:Humans; D055370:Lung Injury / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000401:mortality* / Q000473:pathology*; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D018805:Sepsis / Q000401:mortality* / Q000473:pathology*