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Extravascular lung water

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https://www.readbyqxmd.com/read/29055604/treatment-of-primary-graft-dysfunction-after-lung-transplantation-with-orally-inhaled-ap301-a-prospective-randomized-pilot-study
#1
Clemens Aigner, Alexis Slama, Maximilian Barta, Andreas Mitterbauer, Gyoergy Lang, Shahrokh Taghavi, Jose Matilla, Roman Ullrich, Katharina Krenn, Peter Jaksch, Klaus Markstaller, Walter Klepetko
BACKGROUND: Primary graft dysfunction (PGD) after lung transplantation (LTx) carries significant morbidity and mortality in the early post-operative period and is associated with the development of chronic lung allograft dysfunction. AP301, an activator of epithelial sodium channel-mediated Na(+) uptake represents a new concept for prevention and treatment of pulmonary edema and has shown promising results in the pre-clinical setting. This pilot study investigated the clinical effect of inhaled AP301 on patients with development of PGD > 1 according to International Society of Heart and Lung Transplantation criteria after primary LTx in a high-volume center and was conducted as a randomized, placebo-controlled, single-center pilot-study including 20 patients...
September 30, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29040264/comparison-of-pulmonary-vascular-permeability-index-pvpi-and-global-ejection-fraction-gef-derived-from-jugular-and-femoral-indicator-injection-using-the-picco-2-device-a-prospective-observational-study
#2
COMPARATIVE STUDY
Wolfgang Huber, Andrea Gruber, Maximilian Eckmann, Felicia Elkmann, Ines Klein, Tobias Lahmer, Ulrich Mayr, Raphael Schellnegger, Jochen Schneider, Gonzalo Batres-Baires, Lisa Fekecs, Analena Beitz, Helena Berbara, Roland Schmid, Alexander Herner
BACKGROUND: Transpulmonary thermodilution (TPTD) is used to derive cardiac output CO, global end-diastolic volume GEDV and extravascular lung water EVLW. To facilitate interpretation of these data, several ratios have been developed, including pulmonary vascular permeability index (defined as EVLW/(0.25*GEDV)) and global ejection fraction ((4*stroke volume)/GEDV). PVPI and GEF have been associated to the aetiology of pulmonary oedema and systolic cardiac function, respectively. Several studies demonstrated that the use of femoral venous access results in a marked overestimation of GEDV...
2017: PloS One
https://www.readbyqxmd.com/read/28982177/adipose-derived-stem-cells-attenuate-pulmonary-microvascular-hyperpermeability-after-smoke-inhalation
#3
Koji Ihara, Satoshi Fukuda, Baigalmaa Enkhtaivan, Raul Trujillo, Dannelys Perez-Bello, Christina Nelson, Anita Randolph, Suzan Alharbi, Hira Hanif, David Herndon, Donald Prough, Perenlei Enkhbaatar
BACKGROUND: Pulmonary edema is a hallmark of acute respiratory distress syndrome (ARDS). Smoke inhalation causes ARDS, thus significantly increasing the mortality of burn patients. Adipose-derived stem cells (ASCs) exert potent anti-inflammatory properties. The goal of the present study was to test the safety and ecfficacy of ASCs, in a well-characterized clinically relevant ovine model of ARDS. METHODS: Female sheep were surgically prepared. ARDS was induced by cooled cotton smoke inhalation...
2017: PloS One
https://www.readbyqxmd.com/read/28975560/observational-study-of-potential-risk-factors-of-immersion-pulmonary-edema-in-healthy-divers-exercise-intensity-is-the-main-contributor
#4
A Boussuges, K Ayme, G Chaumet, E Albier, M Borgnetta, O Gavarry
BACKGROUND: The risk factors of pulmonary edema induced by diving in healthy subjects are not well known. The aim of the present study was to assess the parameters contributing to the increase in extravascular lung water after diving. METHODS: This study was carried out in a professional diving institute. All divers participating in the teaching program from June 2012 to June 2014 were included in the study. Extravascular lung water was assessed using the detection of ultrasound lung comets (ULC) by chest ultrasonography...
October 3, 2017: Sports Medicine—Open
https://www.readbyqxmd.com/read/28975489/use-of-lung-ultrasonography-to-determine-the-accuracy-of-clinically-estimated-dry-weight-in-chronic-hemodialysis-patients
#5
Chuan Jiang, Satyam Patel, Andrew Moses, Maria V DeVita, Michael F Michelis
PURPOSE: The use of lung ultrasound (LUS) to identify extravascular lung water has received increasing acceptance. Sonographic B-lines, discrete vertical lines that originate from the pleura, represent pulmonary edema and are correlated with the accumulation of fluid. The goal of this study was to evaluate the utility of LUS to determine the accuracy of prescribed dry weight (DW) in chronic hemodialysis (HD) patients and to ascertain the adequacy of fluid removal. METHODS: LUS was scheduled to be performed pre- and post-HD in 20 patients...
December 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28904478/how-useful-is-extravascular-lung-water-measurement-in-managing-lung-injury-in-intensive-care-unit
#6
Anirban Bhattacharjee, Debasis Pradhan, Prithwis Bhattacharyya, Samarjit Dey, Daniala Chhunthang, Akash Handique, Angkita Barman, Mohd Yunus
CONTEXT: The primary goal of septic shock management is optimization of organ perfusion, often at the risk of overloading the interstitium and causing pulmonary edema. The conventionally used end points of resuscitation do not generally include volumetric parameters such as extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI). AIMS: This study aimed to assess the prognostic value of EVLWI and PVPI by calculating their correlation with the severity of lung injury...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28876128/influence-of-inhaled-amiloride-on-lung-fluid-clearance-in-response-to-normobaric-hypoxia-in-healthy-individuals
#7
Courtney M Wheatley, Sarah E Baker, Bryan J Taylor, Manda L Keller-Ross, Steven C Chase, Alex R Carlson, Robert J Wentz, Eric M Snyder, Bruce D Johnson
Wheatley, Courtney M., Sarah E. Baker, Bryan J. Taylor, Manda L. Keller-Ross, Steven C. Chase, Alex R. Carlson, Robert J. Wentz, Eric M. Snyder, and Bruce D. Johnson. Influence of inhaled amiloride on lung fluid clearance in response to normobaric hypoxia in healthy individuals. High Alt Med Biol 00:000-000, 2017. AIM: To investigate the role of epithelial sodium channels (ENaC) on lung fluid clearance in response to normobaric hypoxia, 20 healthy subjects were exposed to 15 hours of hypoxia (fraction of inspired oxygen [FiO2] = 12...
September 6, 2017: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/28865726/b-lines-with-lung-ultrasound-the-optimal-scan-technique-at%C3%A2-rest-and-during-stress
#8
Maria Chiara Scali, Angela Zagatina, Iana Simova, Nadezhda Zhuravskaya, Quirino Ciampi, Marco Paterni, Mario Marzilli, Clara Carpeggiani, Eugenio Picano
Various lung ultrasound (LUS) scanning modalities have been proposed for the detection of B-lines, also referred to as ultrasound lung comets, which are an important indication of extravascular lung water at rest and after exercise stress echo (ESE). The aim of our study was to assess the lung water spatial distribution (comet map) at rest and after ESE. We performed LUS at rest and immediately after semi-supine ESE in 135 patients (45 women, 90 men; age 62 ± 12 y, resting left ventricular ejection fraction = 41 ± 13%) with known or suspected heart failure or coronary artery disease...
November 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28831765/validation-of-transpulmonary-thermodilution-variables-in-hemodynamically-stable-patients-with-heart-diseases
#9
Matthias Peter Hilty, Daniel Peter Franzen, Christophe Wyss, Patric Biaggi, Marco Maggiorini
BACKGROUND: Transpulmonary thermodilution is recommended in the treatment of critically ill patients presenting with complex shock. However, so far it has not been validated in hemodynamically stable patients with heart disease. METHODS: We assessed the validity of cardiac output, global end-diastolic volume index (GEDVI), an established marker of preload thought to reflect the volume of all four heart chambers, global ejection fraction (GEF) and cardiac function index (CFI) as variables of cardiac function, and extravascular lung water index (EVLWI) as indicator of pulmonary edema in 29 patients undergoing elective left and right heart catheterization including left ventricular angiography with stable coronary heart disease and normal cardiac function (controls, n = 11), moderate-to-severe aortic valve stenosis (AS, n = 10), or dilated cardiomyopathy (DCM, n = 8)...
August 22, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28750677/inhaled-ap301-for-treatment-of-pulmonary-edema-in-mechanically-ventilated-patients-with-acute-respiratory-distress-syndrome-a-phase-iia-randomized-placebo-controlled-trial
#10
Katharina Krenn, Rudolf Lucas, Adrien Croizé, Stefan Boehme, Klaus Ulrich Klein, Robert Hermann, Klaus Markstaller, Roman Ullrich
BACKGROUND: High-permeability pulmonary edema is a hallmark of acute respiratory distress syndrome (ARDS) and is frequently accompanied by impaired alveolar fluid clearance (AFC). AP301 enhances AFC by activating epithelial sodium channels (ENaCs) on alveolar epithelial cells, and we investigated its effect on extravascular lung water index (EVLWI) in mechanically ventilated patients with ARDS. METHODS: Forty adult mechanically ventilated patients with ARDS were included in a randomized, double-blind, placebo-controlled trial for proof of concept...
July 27, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28746224/alveolar-recruitment-maneuver-attenuates-extravascular-lung-water-in-acute-respiratory-distress-syndrome
#11
RANDOMIZED CONTROLLED TRIAL
Fu-Tsai Chung, Chung-Shu Lee, Shu-Min Lin, Chih-Hsi Kuo, Tsai-Yu Wang, Yueh-Fu Fang, Meng-Heng Hsieh, Hao-Cheng Chen, Horng-Chyuan Lin
BACKGROUND: The alveolar recruitment maneuver (RM) has been reported to improve oxygenation in acute respiratory distress syndrome (ARDS) and may be related to reduced extravascular lung water (EVLW) in animals. This study was designed to investigate the effects of RM on EVLW in patients with ARDS. METHODS: An open label, prospective, randomized controlled trial including patients with ARDS was conducted in hospitals in North Taiwan between 2010 and 2016. The patients were divided into 2 groups (with and without RM)...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28724041/effect-of-rhubarb-on-extravascular-lung-water-in-patients-with-acute-respiratory-distress-syndrome
#12
RANDOMIZED CONTROLLED TRIAL
Jianxin He, Xiaoshui Si, Mingxia Ji, Jing Huang, Wenjuan Zheng, Jiao Wang, Junfeng Wang, Lijun Zhu
Objective: The aim of this study was to evaluate the effect of rhubarb on extravascular lung water (EVLW) in patients with acute respiratory distress syndrome (ARDS). Method: A total of 80 patients with ARDS were randomly divided into a treatment group (40 cases) and control group (40 cases). Patients in the treatment group received rhubarb (30.0 g/d) and patients in the control group received conventional therapy for seven consecutive days. Extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI) were determined using pulse contour cardiac output (PiCCO) technology, and the oxygenation index was measured by blood gas analysis at baseline and on days 3, 5 and 7 after treatment...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28716688/influence-of-thoracic-fluid-compartments-on-pulmonary-congestion-in-chronic-heart-failure
#13
Steven C Chase, Bryan J Taylor, Troy J Cross, Kirsten E Coffman, Lyle J Olson, Bruce D Johnson
INTRODUCTION: Pulmonary congestion is a common finding of heart failure (HF), but it remains unclear how pulmonary and heart blood volumes (Vp and Vh, respectively) and extravascular lung water (EVLW) change in stable HF and affect lung function. METHODS: Fourteen patients with HF (age 68 ± 11 y, LVEF 33 ± 8%) and 12 control subjects (age 65 ± 9 y) were recruited. A pulmonary function test, thoracic computerized tomographic (CT) scan, and contrast perfusion scan were performed...
September 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28690287/stroke-volume-variation-svv-and-pulse-pressure-variation-ppv-as-indicators-of-fluid-responsiveness-in-sevoflurane-anesthetized-mechanically-ventilated-euvolemic-dogs
#14
Yusuke Endo, Jun Tamura, Tomohito Ishizuka, Takaharu Itami, Kiwamu Hanazono, Kenjiro Miyoshi, Tadashi Sano, Kazuto Yamashita, William W Muir
Changes in stroke volume variation (SVV) and pulse pressure variation (PPV) in response to fluid infusion were experimentally evaluated during vecuronium infusion and sevoflurane anesthesia in 5 adult, mechanically ventilated, euvolemic, beagle dogs. Sequential increases in central venous pressure (CVP; 3-7[baseline], 8-12, 13-17, 18-22 and 23-27 mmHg) were produced by infusing lactated Ringer's solution and 6% hydroxyethyl starch solution. Heart rate (beats/min), right atrial pressure (RAP, mmHg), pulmonary arterial pressure (PAP, mmHg), pulmonary capillary wedge pressure (PCWP, mmHg), transpulmonary thermodilution cardiac output (TPTDCO, l/min), stroke volume (SV, ml/beat), arterial blood pressure (ABP, mmHg), extravascular lung water (EVLW, ml), pulmonary vascular permeability index (PVPI, calculated), SVV (%), PPV (%) and systemic vascular resistance (SVR, dynes/sec/cm(5)) were determined at each predetermined CVP range...
August 18, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28625256/-comparison-of-effect-of-norepinephrine-and-terlipressin-on-patients-with-ards-combined-with-septic-shock-a-prospective-single-blind-randomized-controlled-trial
#15
Zhi Chen, Ping Zhou, Yuanhua Lu, Chunli Yang
OBJECTIVE: To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock. METHODS: A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625234/-effect-of-global-end-diastolic-volume-index-guidance-fluid-resuscitation-in-elderly-patients-with-septic-shock
#16
Shuang Ma, Rumin Zhang, Shifu Wang, Meiling Zhao, Lei Wang, Yun Zhang
OBJECTIVE: To evaluate the effect of global end diastolic volume index (GEDVI) on fluid resuscitation in elderly patients with septic shock. METHODS: A prospective randomized controlled trial (RCT) was conducted. Septic shock patients over 65 years admitted to intensive care unit (ICU) of Shandong Province, Zibo Central Hospital from January 2013 to December 2015 were enrolled. The patients were randomly divided into control group and observation group, 20 cases in each group...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625165/transpulmonary-thermodilution-advantages-and-limits
#17
REVIEW
Xavier Monnet, Jean-Louis Teboul
BACKGROUND: For complex patients in the intensive care unit or in the operating room, many questions regarding their haemodynamic management cannot be answered with simple clinical examination. In particular, arterial pressure allows only a rough estimation of cardiac output. Transpulmonary thermodilution is a technique that provides a full haemodynamic assessment through cardiac output and other indices. MAIN BODY: Through the analysis of the thermodilution curve recorded at the tip of an arterial catheter after the injection of a cold bolus in the venous circulation, transpulmonary thermodilution intermittently measures cardiac output...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28612302/a-simplified-lung-ultrasound-approach-to-detect-increased-extravascular-lung-water-in-critically-ill-patients
#18
Antonio Anile, Jole Russo, Giacomo Castiglione, Giovanni Volpicelli
BACKGROUND: The quantification of B-lines at lung ultrasonography is a valid tool to estimate the extravascular lung water (EVLW) in patients after major cardiac surgery. However, there is still uncertainty about the correlation between B-lines and EVLW in a general population of critically ill. AIM: To evaluate a simplified lung ultrasonographic assessment as a tool to estimate the EVLW in critically ill patients admitted to a polyvalent intensive care unit (ICU)...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28606680/pulmonary-congestion-evaluated-by-lung-ultrasound-predicts-decompensation-in-heart-failure-outpatients
#19
Marcelo H Miglioranza, Eugenio Picano, Luigi P Badano, Roberto Sant'Anna, Marciane Rover, Facundo Zaffaroni, Rosa Sicari, Renato K Kalil, Tiago L Leiria, Luna Gargani
BACKGROUND: Pulmonary congestion is the main cause of hospital admission among heart failure (HF) patients. Lung ultrasound (LUS) assessment of B-lines has been recently proposed as a reliable and easy tool for evaluating pulmonary congestion. OBJECTIVE: To determine the prognostic value of LUS in predicting adverse events in HF outpatients. METHODS: Single-center prospective cohort of 97 moderate-to-severe systolic HF patients (53±13years; 61% males) consecutively enrolled between November 2011 and October 2012...
August 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28598919/cardiorespiratory-alterations-following-acute-normovolemic-hemodilution-in-a-pediatric-and-an-adult-porcine-model-a-prospective-interventional-study
#20
Gergely Albu, Cédric Sottas, Mirko Dolci, Magali Walesa, Ferenc Peták, Walid Habre
BACKGROUND: Acute normovolemic hemodilution (ANH) is considered as a blood-sparing intervention during the perioperative management. We aimed at comparing the cardiopulmonary consequences of ANH between adult pigs and weaned piglets to establish the effects of lowering hematocrit in these age groups, and thereby testing the hypothesis that difference in the age-related physiological behavior will be reflected in the cardiorespiratory changes following ANH. METHODS: ANH was achieved in anesthetized, mechanically ventilated adult minipigs and 5-week-old weaned piglets by stepwise blood withdrawal (10 mL/kg) with crystalloids replacement...
June 8, 2017: Anesthesia and Analgesia
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