Critical Care

official impact factor 4.60
Search for
Advanced search
Critical Care
Tools
Open Access Highly Access Research

Validation of extravascular lung water measurement by single transpulmonary thermodilution: human autopsy study

Takashi Tagami1*, Shigeki Kushimoto2, Yasuhiro Yamamoto3, Takahiro Atsumi2, Ryoichi Tosa1, Kiyoshi Matsuda4, Renpei Oyama5, Takanori Kawaguchi6, Tomohiko Masuno2, Hisao Hirama1 and Hiroyuki Yokota2

Author Affiliations

1 Department of Emergency and Critical Care Medicine, Aidu Chuo Hospital, 1-1 Tsuruga, Aiduwakamatsu, Fukushima, 965-8611, Japan

2 Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8613, Japan

3 Tokyo Rinkai Hospital, 1-4-2 Rinkaicho, Edogawa-ku, Tokyo, 134-0086, Japan

4 Department of Emergency and Critical Care Medicine, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan

5 Department of Surgery, Saiseikai Chuo Hospital, 1-4-17 Mita, Minato-ku, Tokyo, 108-0073, Japan

6 Department of Pathology, Aidu Chuo Hospital, 1-1 Tsuruga, Aiduwakamatsu, Fukushima, 965-8611, Japan

For all author emails, please log on.

Critical Care 2010, 14:R162 doi:10.1186/cc9250

Published: 6 September 2010

Abstract

Introduction

Gravimetric validation of single-indicator extravascular lung water (EVLW) and normal EVLW values has not been well studied in humans thus far. The aims of this study were (1) to validate the accuracy of EVLW measurement by single transpulmonary thermodilution with postmortem lung weight measurement in humans and (2) to define the statistically normal EVLW values.

Methods

We evaluated the correlation between pre-mortem EVLW value by single transpulmonary thermodilution and post-mortem lung weight from 30 consecutive autopsies completed within 48 hours following the final thermodilution measurement. A linear regression equation for the correlation was calculated. In order to clarify the normal lung weight value by statistical analysis, we conducted a literature search and obtained the normal reference ranges for post-mortem lung weight. These values were substituted into the equation for the correlation between EVLW and lung weight to estimate the normal EVLW values.

Results

EVLW determined using transpulmonary single thermodilution correlated closely with post-mortem lung weight (r = 0.904, P < 0.001). A linear regression equation was calculated: EVLW (mL) = 0.56 × lung weight (g) - 58.0. The normal EVLW values indexed by predicted body weight were approximately 7.4 ± 3.3 mL/kg (7.5 ± 3.3 mL/kg for males and 7.3 ± 3.3 mL/kg for females).

Conclusions

A definite correlation exists between EVLW measured by the single-indicator transpulmonary thermodilution technique and post-mortem lung weight in humans. The normal EVLW value is approximately 7.4 ± 3.3 mL/kg.

Trial registration

UMIN000002780.