title: Prognostic value of extravascular lung water index in critically ill patients: a systematic review of the literature.
abstract: BACKGROUND
  The prognostic value of extravascular lung water (EVLW) has been widely investigated; however, a wide range of its predictive accuracy has been reported.
  
  
  METHODS
  A meta-analysis of diagnostic test studies was conducted.
  
  
  METHODS
  Various patient populations in the intensive care unit were included, such as burned patients and patients with acute lung injury/acute respiratory distress syndrome and sepsis.
  
  
  METHODS
  A computerized search of PubMed, Current Contents, CINAHL, and EMBASE from inception until March 1, 2011, was performed to identify potentially relevant articles. The inclusion criteria were studies investigating the prognostic value of EVLW in critically ill patients. There was no language restriction in the searching.
  
  
  METHODS
  The EVLW index (EVLWI) was used.
  
  
  METHODS
  The outcome was mortality (including in-hospital mortality, intensive care unit mortality, and 28-day mortality).
  
  
  RESULTS
  We analyzed data from 11 studies and 9 countries involving 670 patients. Overall, the EVLWI was significantly higher in nonsurvivors than in survivors, with a mean difference of 5.06 mL/kg (95% confidence interval, -7.53 to -2.58). The heterogeneity was significant with I(2) = 90%. The pooled statistics of diagnostic accuracy together with relevant 95% confidence interval were as follows: sensitivity, 0.81 (0.72-0.88); specificity, 0.66 (0.55-0.76); diagnostic odds ratio, 8.84 (3.83-20.4), positive likelihood ratio, 2.44 (1.69-3.52); negative likelihood ratio, 0.28 (0.16-0.46).
  
  
  CONCLUSIONS
  The sample sizes of included studies were small.
  
  
  CONCLUSIONS
  The EVLWI appears to be a good predictor of mortality in critically ill patients.
authors.affiliation: Department of Critical Care Medicine, Jinhua Central Hospital, Zhejiang 321000, PR China. zh_zhang1984@hotmail.com
authors.forename: Zhongheng
authors.initials: Z
authors.lastname: Zhang
authors.forename: Baolong
authors.initials: B
authors.lastname: Lu
authors.forename: Hongying
authors.initials: H
authors.lastname: Ni
mesh_terms: D000367:Age Factors; D016638:Critical Illness / Q000401:mortality*; D015633:Extravascular Lung Water; D006305:Health Status Indicators; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D011379:Prognosis; D016019:Survival Analysis