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Extravascular lung water

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https://www.readbyqxmd.com/read/29752666/lung-water-assessment-from-gravimetry-to-wearables
#1
Frederic Michard
Several techniques are now available to detect and quantify pulmonary edema, from the laboratory postmortem method (gravimetry) to non-invasive wearable sensors. In critically ill patients with adult respiratory distress syndrome (ARDS), computed tomography scans are often performed to visualize lung lesions and quantify lung aeration, but their value seems somewhat limited to quantify pulmonary edema on a routine basis and of course to track changes with therapy. In this context, transpulmonary thermodilution is a convenient technique...
May 11, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29743121/high-frequency-oscillatory-ventilation-guided-by-transpulmonary-pressure-in-acute-respiratory-syndrome-an-experimental-study-in-pigs
#2
Philipp Klapsing, Onnen Moerer, Christoph Wende, Peter Herrmann, Michael Quintel, Annalen Bleckmann, Jan Florian Heuer
BACKGROUND: Recent clinical studies have not shown an overall benefit of high-frequency oscillatory ventilation (HFOV), possibly due to injurious or non-individualized HFOV settings. We compared conventional HFOV (HFOVcon ) settings with HFOV settings based on mean transpulmonary pressures (PLmean ) in an animal model of experimental acute respiratory distress syndrome (ARDS). METHODS: ARDS was induced in eight pigs by intrabronchial installation of hydrochloric acid (0...
May 9, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29691755/my-patient-has-received-fluid-how-to-assess-its-efficacy-and-side-effects
#3
REVIEW
Xavier Monnet, Jean-Louis Teboul
Many efforts have been made to predict, before giving fluid, whether it will increase cardiac output. Nevertheless, after fluid administration, it is also essential to assess the therapeutic efficacy and to look for possible adverse effects. Like for any drug, this step should not be missed. Basically, volume expansion is aimed at improving tissue oxygenation and organ function. To assess this final result, clinical signs are often unhelpful. The increase in urine output in case of acute kidney injury is a poor marker of the kidney perfusion improvement...
April 24, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29682549/preliminary-exploration-of-epidemiologic-and-hemodynamic-characteristics-of-restrictive-filling-diastolic-dysfunction-based-on-echocardiography-in-critically-ill-patients-a-retrospective-study
#4
Yi Li, Wanhong Yin, Yao Qin, Xueying Zeng, Tongjuan Zou, Xiaoting Wang, Yangong Chao, Lina Zhang, Yan Kang, Chinese Critical Ultrasound Study Group Ccusg
Objective: To preliminarily describe the epidemiologic and hemodynamic characteristics of critically ill patients with restrictive filling diastolic dysfunction based on echocardiography. Setting: A retrospective study. Methods: Epidemiologic characteristics of patients with restrictive filling diastolic dysfunction in ICU were described; clinical and hemodynamic data were preliminarily summarized and compared between patients with and without restrictive filling diastolic dysfunction; most of the data were based on echocardiography...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29680878/quantitative-computed-tomography-in-comparison-with-transpulmonary-thermodilution-for-the-estimation-of-pulmonary-fluid-status-a-clinical-study-in-critically-ill-patients
#5
Bernd Saugel, Moritz Wildgruber, Albrecht Staudt, Michael Dieckmeyer, Konstantin Holzapfel, Georgios Kaissis, Mikhail Y Kirov, Vsevolod V Kuzkov, Roland M Schmid, Wolfgang Huber
Extravascular lung water (index) (EVLW(I)) can be estimated using transpulmonary thermodilution (TPTD). Computed tomography (CT) with quantitative analysis of lung tissue density has been proposed to quantify pulmonary edema. We compared variables of pulmonary fluid status assessed using quantitative CT and TPTD in critically ill patients. In 21 intensive care unit patients, we performed TPTD measurements directly before and after chest CT. Based on the density data of segmented CT images we calculated the tissue volume (TV), tissue volume index (TVI), and the mean weighted index of voxel aqueous density (VMWaq)...
April 21, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29678727/assessment-of-thoracic-blood-volume-by-computed-tomography-in-patients-with-heart-failure-and-periodic-breathing
#6
Caitlin C Fermoyle, Steven C Chase, Lyle J Olson, Bruce D Johnson
BACKGROUND: Periodic breathing (PB) is often observed in patients with HF at rest, with sleep and during exercise. However, mechanisms underlying abnormal ventilatory control are not entirely established. METHODS: Eleven subjects with HF (10M, age=69±12yr) and 12 age-matched controls (8M, age=65±9yr) participated in the study. PB was defined as a peak in the 0.003-0.04Hz frequency range of the flow signal during 6-minutes of awake resting breathing. Thoracic blood volumes (Vt , thorax; Vh , heart; Vp , pulmonary), mean transit times (MTT) and extravascular lung water (EVLW) were quantified using computed tomography...
April 17, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29644056/lung-ultrasonography-in-end-stage-renal-disease-moving-from-evidence-to-practice-a-narrative-review
#7
Daniel W Ross, Mohammed M Abbasi, Kenar D Jhaveri, Mala Sachdeva, Ilene Miller, Richard Barnett, Mangala Narasimhan, Paul Mayo, Massini Merzkani, Anna T Mathew
Traditionally, point of care ultrasonography in nephrology has been used for renal biopsies and dialysis line placement. However, there is an emerging literature supporting the value of point of care lung ultrasonography in the assessment of volume status for dialysis patients. We conducted a review and identified 12 studies that examined the utility of lung ultrasonography in assessing volume status in patients with end-stage renal disease. We conclude that lung ultrasonography can be used to determine volume status in chronic dialysis patients by identifying lung congestion using the B-line score...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29617006/relevance-of-b-lines-on-lung-ultrasound-in-volume-overload-and-pulmonary-congestion-clinical-correlations-and-outcomes-in-patients-on-hemodialysis
#8
Marc M Saad, Jeanne Kamal, Elias Moussaly, Boutros Karam, Wissam Mansour, Emad Gobran, Saqib Hussen Abbasi, Ahmed Mahgoub, Puja Singh, Ross Hardy, Devjani Das, Cara Brown, Monica Kapoor, Seleshi Demissie, Morton J Kleiner, Elie El Charabaty, Suzanne E El Sayegh
BACKGROUND: Volume overload in patients on hemodialysis (HD) is an independent risk factor for cardiovascular mortality. B-lines detected on lung ultrasound (BLUS) assess extravascular lung water. This raises interest in its utility for assessing volume status and cardiovascular outcomes. METHODS: End-stage renal disease patients on HD at the Island Rehab Center being older than 18 years were screened. Patients achieving their dry weight (DW) had a lung ultrasound in a supine position...
2018: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29608455/extravascular-lung-water-measurements-in-acute-respiratory-distress-syndrome-why-how-and-when
#9
Takashi Tagami, Marcus Eng Hock Ong
PURPOSE OF REVIEW: Increase in pulmonary vascular permeability accompanied with accumulation of excess extravascular lung water (EVLW) is the hallmark of acute respiratory distress syndrome (ARDS). Currently, EVLW and pulmonary vascular permeability index (PVPI) can be quantitatively measured using the transpulmonary thermodilution (TPTD) technique. We will clarify why, how, and when EVLW and PVPI measurements should be performed. RECENT FINDINGS: Although the Berlin criteria of ARDS are simple and widely used, several criticisms of them have been published...
June 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29538440/impact-of-large-volume-paracentesis-on-respiratory-parameters-including-transpulmonary-pressure-and-on-transpulmonary-thermodilution-derived-hemodynamics-a-prospective-study
#10
Ulrich Mayr, Eugen Karsten, Tobias Lahmer, Sebastian Rasch, Philipp Thies, Benedikt Henschel, Gerrit Fischer, Roland M Schmid, Wolfgang Huber
INTRODUCTION: Appropriate mechanical ventilation and prevention of alveolar collaps is mainly dependent on transpulmonary pressure TPP. TPP is assessed by measurement of esophageal pressure EP, largely influenced by pleural and intraabdominal pressure IAP. Consecutively, TPP-guided ventilation might be particularly useful in patients with high IAP. This study investigates the impact of large volume paracentesis LVP on TPP, EP, IAP as well as on hemodynamic and respiratory function in patients with liver cirrhosis and tense ascites...
2018: PloS One
https://www.readbyqxmd.com/read/29487872/a-simplified-ultrasound-comet-tail-grading-scoring-to-assess-pulmonary-congestion-in-patients-with-heart-failure
#11
Hong Li, Yi-Dan Li, Wei-Wei Zhu, Ling-Yun Kong, Xiao-Guang Ye, Qi-Zhe Cai, Lan-Lan Sun, Xiu-Zhang Lu
Ultrasound lung comets (ULCs) are a nonionizing bedside approach to assess extravascular lung water. We evaluated a protocol for grading ULC score to estimate pulmonary congestion in heart failure patients and investigated clinical and echocardiographic correlates of the ULC score. Ninety-three patients with congestive heart failure, admitted to the emergency department, underwent pulmonary ultrasound and echocardiography. A ULC score was obtained by summing the ULC scores of 7 zones of anterolateral chest scans...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29465202/-lung-ultrasound-in-patients-with-hematological-malignancies-and-acute-respiratory-failure-due-to-pneumonia
#12
V A Novikov, G M Galstyan, I An E G Gemdzh, I E Kostina, M K Gitis
PURPOSE: To compare the accuracy of bedside lung ultrasound (LUS) and chest computed tomography (CT) for the de- tection of lung lesions in patients with hematological malignancies and acute respiratory failure (ARF). MATERIALS AND METHODS: 39 patients with hematological malignancies and ARF were enrolled in prospective study. The investigation of the patients included LUS, chest C, extravascular lung water index (EVLW) by transpulmonary ther- modilution, and bronchoalveolar lavage (BAL)...
September 2017: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/29377300/effects-of-6-tetrastarch-and-lactated-ringer-s-solution-on-extravascular-lung-water-and-markers-of-acute-renal-injury-in-hemorrhaged-isoflurane-anesthetized-healthy-dogs
#13
M S Diniz, F J Teixeira-Neto, N Celeita-Rodríguez, C H Girotto, M W Fonseca, A C Oliveira-Garcia, B López-Castañeda
BACKGROUND: Tetrastarch can cause acute kidney injury (AKI) in humans with sepsis, but less likely to result in tissue edema than lactated Ringer's solution (LRS). OBJECTIVES: Compare effects of volume replacement (VR) with LRS and 6% tetrastarch solution (TS) on extravascular lung water (EVLW) and markers of AKI in hemorrhaged dogs. ANIMALS: Six healthy English Pointer dogs (19.7-35.3 kg). METHODS: Prospective crossover study...
March 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29374922/-effects-of-application-of-pulse-contour-cardiac-output-monitoring-technology-in-early-treatment-of-patients-with-large-area-burns
#14
D Y Wang, W G Xie, M M Xi, Z Li, B Wang
Objective: To analyze the changes and relationship of early hemodynamic indexes of patients with large area burns monitored by pulse contour cardiac output (PiCCO) monitoring technology, so as to assess the guiding value of this technology in the treatment of patients with large area burns during shock period. Methods: Eighteen patients with large area burns, confirming to the study criteria, were admitted to our unit from May 2016 to May 2017. Pulse contour cardiac output index (PCCI), systemic vascular resistance index (SVRI), global end-diastolic volume index (GEDVI), and extravascular lung water index (EVLWI) of patients were monitored by PiCCO instrument from admission to post injury day (PID) 7, and they were calibrated and recorded once every four hours...
January 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29345431/the-effect-of-diuresis-on-extravascular-lung-water-and-pulmonary-function-in-acute-decompensated-heart-failure
#15
Steven C Chase, Caitlin C Fermoyle, Courtney M Wheatley, Jacob J Schaefer, Lyle J Olson, Bruce D Johnson
AIMS: The effect of extravascular lung water (EVLW) and relationship to functional status as a result of acute decompensated heart failure (ADHF) are not well understood. We sought to quantify changes in clinical variables, EVLW, airway anatomy, spirometry, and diffusing capacity for carbon monoxide before and after treatment for ADHF. METHODS AND RESULTS: Fifteen patients were recruited within 24 h of hospital admission. Spirometry, diffusing capacity for carbon monoxide, and surrogates of EVLW by computed tomography were measured and were then repeated within 24 h of discharge...
January 18, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29313715/fluid-balance-is-associated-with-clinical-outcomes-and-extravascular-lung-water-in-children-with-acute-asthma-exacerbation
#16
David B Kantor, Eliotte L Hirshberg, Molly C McDonald, Jonathan Griffin, Tess Buccigrosso, Nicole Stenquist, Craig D Smallwood, Kyle A Nelson, David Zurakowski, Wanda Phipatanakul, Joel N Hirschhorn
RATIONALE: The effects of fluid administration during acute asthma exacerbation are likely unique in this patient population: highly negative inspiratory intrapleural pressure resulting from increased airway resistance may interact with excess fluid administration to favor the accumulation of extravascular lung water, leading to worse clinical outcomes. OBJECTIVES: Investigate how fluid balance influences clinical outcomes in children hospitalized for asthma exacerbation...
January 9, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29304201/short-term-outcomes-of-minimally-invasive-mitral-valve-repair-a-propensity-matched-comparison
#17
Qing Wang, Wang Xi, Yang Gao, Hua Shen, Jie Min, Jie Yang, Shiguan Le, Yufeng Zhang, Zhinong Wang
OBJECTIVES: We aimed to investigate the effect of minimally invasive mitral valve repair on early pulmonary function and haemodynamics, as well as its short-term efficacy. METHODS: From March 2012 to July 2015, 78 cases of minimally invasive mitral valve repair and 89 cases of conventional mitral valve repair were included in this study, with 67 well-matched pairs of patients identified by a propensity score matching, who were divided into the conventional sternotomy group and the right minithoracotomy group (the RT group)...
January 3, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29274919/use-of-lung-ultrasound-for-the-assessment-of-volume-status-in-ckd
#18
REVIEW
Adrian Covic, Dimitrie Siriopol, Luminita Voroneanu
Adequate assessment of fluid status is an imperative objective in the management of all types of patients in cardiology, intensive care, and especially nephrology. Fluid overload is one of the most common modifiable risk factors directly associated with hypertension, heart failure, left ventricular hypertrophy, and eventually, higher morbidity and mortality risk in these categories of patients. Different methods are commonly used to determine fluid status (eg, clinical assessment, natriuretic peptide concentrations, echocardiography, inferior vena cava measurements, or bioimpedance analysis)...
March 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29221300/comparison-of-continuous-compression-with-regular-ventilations-versus-30-2-compressions-ventilations-strategy-during-mechanical-cardiopulmonary-resuscitation-in-a-porcine-model-of-cardiac-arrest
#19
Zhengfei Yang, Qingyu Liu, Guanghui Zheng, Zhifeng Liu, Longyuan Jiang, Qing Lin, Rui Chen, Wanchun Tang
Background: A compression-ventilation (C:V) ratio of 30:2 is recommended for adult cardiopulmonary resuscitation (CPR) by the current American Heart Association (AHA) guidelines. However, continuous chest compression (CCC) is an alternative strategy for CPR that minimizes interruption especially when an advanced airway exists. In this study, we investigated the effects of 30:2 mechanical CPR when compared with CCC in combination with regular ventilation in a porcine model. Methods: Sixteen male domestic pigs weighing 39±2 kg were utilized...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29216627/a-simplified-approach-to-extravascular-lung-water-assessment-using-point-of-care-ultrasound-in-patients-with-end-stage-chronic-renal-failure-undergoing-hemodialysis
#20
William Beaubien-Souligny, Maxime Rhéaume, Marie-Christine Blondin, Shérine El-Barnachawy, Annik Fortier, Jean Éthier, Louis Legault, André Y Denault
BACKGROUND: Fluid overload leading to pulmonary congestion is an important issue in patients undergoing hemodialysis. This study aimed to determine if a simplified method of extravascular lung water assessment using ultrasound provided clinically relevant information. METHODS: This prospective study recruited 47 patients from a single hemodialysis center. Pulmonary ultrasound was performed before and after 2 hemodialysis sessions in 28 regions on the thorax. The B-line score was defined as the percentage regions where B-lines were present...
December 7, 2017: Blood Purification
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