Value of extravascular lung water measurement vs portable chest x-ray in the management of pulmonary edema.
Sivak ED, Richmond BJ, O'Donavan PB, Borkowski GP.
Variability in technique and reporting time may limit radiographic quantitation of extravascular lung water by portable chest x-ray in critically ill patients. Using double indicator dilution technique and a commercially available lung water computer, we measured extravascular thermal volume (ETVL) in 14 patients with x-ray evidence of pulmonary edema and compared these results to x-ray quantitation of pulmonary edema. The diagnosis of pulmonary edema by interpretation of initial x-rays in each patient's series was 64% accurate as 5 of 14 patients had normal ETVL. Estimation of the magnitude of change in ETVL by radiologic interpretation was 42% accurate. No correlation was found between venous admixture Qsp/Qt, pulmonary capillary wedge pressure (WP) or ETVL values. Measurement of ETVL may aid in the care of critically ill patients with suspected pulmonary edema.
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PMID: 6345087 [PubMed - indexed for MEDLINE]