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Extravascular lung water

Anu K Kaskinen, Laura Martelius, Turkka Kirjavainen, Paula Rautiainen, Sture Andersson, Olli M Pitkänen
BACKGROUND: Lung ultrasounds show vertical artifacts known as B-lines in the presence of increased extravascular lung water (EVLW). We aimed to investigate whether lung ultrasound could estimate EVLW after congenital cardiac surgery. METHODS: This prospective observational study comprised 61 children (age range 3 days to 7.4 years) undergoing congenital cardiac surgery. We compared postoperative B-line scores from lung ultrasounds, early postoperative ultrasound as our primary interest, with corresponding postoperative chest radiography (CXR) lung edema scores, with static lung compliance, and with short-term clinical outcome interpreted as time on mechanical ventilation and length of pediatric intensive care unit (PICU) stay...
October 14, 2016: Pediatric Pulmonology
Jana Ambrozic, Gabrijela Brzan Simenc, Katja Prokselj, Natasa Tul, Marta Cvijic, Miha Lucovnik
OBJECTIVE: To evaluate lung and cardiac ultrasound for assessment of fluid tolerance and fluid responsiveness in severe preeclamptic patients before and after delivery. METHODS: Severe preeclampsia patients and healthy term controls were included in the study. Lung ultrasound Echo Comet Score (ECS) was obtained using the 28-rib interspaces technique. Echocardiographic E/e' ratio, measured by pulsed wave and tissue Doppler, respectively, was used as a marker of diastolic left ventricular function...
October 13, 2016: Ultrasound in Obstetrics & Gynecology
J Ambrozic, K Prokselj, M Lucovnik
INTRODUCTION: The ability to judge intravascular volume is fundamental in the management of patients with severe preeclampsia. Insufficient intravascular volume can result in decreased oxygen delivery to tissues and exacerbates organ dysfunction. On the other hand, fluid excesses can lead to fluid extravasation and pulmonary edema. Outside of pregnancy, transthoracic echocardiography and lung ultrasonography have become important diagnostic and monitoring tools in critically ill patients...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Joanna S Cohen, Naomi Hughes, Sonny Tat, James M Chamberlain, Stephen J Teach, Keith Boniface
OBJECTIVES: Recent literature suggests that bedside lung ultrasound may have a role in the evaluation of infants with bronchiolitis. B lines, which are multiple and diffuse vertical artifacts spreading from the lung pleural interface to the edge of the ultrasound screen, have been associated with thickened interlobular septa, extravascular lung water, and diffuse parenchymal disease. The aims of this study were (1) to describe the prevalence of B lines in children younger than 24 months presenting to the emergency department with wheezing, (2) to determine the interrater reliability of lung ultrasound findings in this setting, and (3) to determine the association of B lines with atopy and other clinical findings...
September 23, 2016: Pediatric Emergency Care
Kuang-Cheng Chan, Chun-Yu Wu, Ming-Hui Hung, Po-Huang Lee, Ya-Jung Cheng
BACKGROUND/PURPOSE: Postoperative acute lung injury (ALI) after liver transplantation is clinically relevant and common. The perioperative thoracic fluid indices changes as well as the association with ALI in liver transplantation have not been thoroughly investigated. METHODS: A total of 52 consecutive adult recipients for elective living donor liver transplantation were enrolled. Each recipient received the same perioperative care plan. Thoracic fluid indices, including the cardiac index, intrathoracic blood volume index (ITBVI), extravascular lung water index (EVLWI), and pulmonary vascular permeability index (PVPI), were obtained at seven time points (pretransplantation, anhepatic phase, 30 minutes after reperfusion, 2 hours after reperfusion, and postoperative days 1-3) using the pulse contour cardiac output system...
September 22, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Bertrand Prunet, Pierre-Yves Cordier, Nicolas Prat, Sophie DE Bourmont, David Couret, Dominique Lambert, Pierre Michelet
OBJECTIVES: This study aimed to assess the short-term respiratory tolerance and haemodynamic efficiency of low-volume resuscitation with hypertonic saline and hydroxyethylstarch (HS/HES) in a pig model of lung contusion and controlled haemorrhagic shock. We hypothesised that a low-volume of HS/HES after haemorrhagic shock didn't impact contused lungs in terms of extravascular lung water 3hours after trauma. METHODS: A lung contusion resulting from blunt chest trauma was induced in 28 anaesthetised female pigs with five bolt shots to the right thoracic cage, followed by haemorrhagic shock and fluid resuscitation...
September 19, 2016: Anaesthesia, Critical Care & Pain Medicine
Bernhard Wernly, Michael Lichtenauer, Marcus Franz, Michael Fritzenwanger, Bjoern Kabisch, Hans-Reiner Figulla, Christian Jung
BACKGROUND: Heart failure is known to be a major public health problem. Fluid redistribution contributes to acute heart failure; therefore, knowledge of hemodynamic parameters could be important for optimizing outcomes. The pulse contour cardiac output monitor PiCCO uses the single thermal indicator technique and pulse contour analysis to calculate hemodynamic parameters of preload, afterload, cardiac output, systemic vascular resistance and extravascular lung water. OBJECTIVES: We primarily aimed to describe values and parameters seen in acute heart failure patients admitted to the intensive care unit (ICU) and secondly to investigate associations between hemodynamic measurements and survival data...
August 15, 2016: Wiener Klinische Wochenschrift
W J Wang, H Q Lu, G Y Sun
No abstract text is available yet for this article.
August 2016: Chinese Journal of Tuberculosis and Respiratory Diseases
Julien Pottecher, Anne-Claude Roche, Tristan Dégot, Olivier Helms, Jean-Gustave Hentz, Jean-Paul Schmitt, Pierre-Emmanuel Falcoz, Nicola Santelmo, François Levy, Olivier Collange, Béatrice Uring-Lambert, Siamak Bahram, Mickaël Schaeffer, Nicolas Meyer, Bernard Geny, Philippe Lassalle, Pierre Diemunsch, Gilbert Massard, Romain Kessler, Annick Steib
BACKGROUND: After lung transplantation (LT), early prediction of grade 3 pulmonary graft dysfunction (PGD) remains a research gap for clinicians. We hypothesized that it could be improved using extravascular lung water (EVLWi) and plasma biomarkers of acute lung injury. METHODS: After institutional review board approval and informed consent, consecutive LT recipients were included. Transpulmonary thermodilution-based EVLWi, plasma concentrations of epithelial (soluble receptor for advanced glycation endproducts [sRAGE]) and endothelial biomarkers (soluble intercellular adhesion molecule-1 [sICAM-1] and endocan [full-length and cleaved p14 fragment]) were obtained before and after LT (0 [H0], 6, 12, 24, 48 and 72h after pulmonary artery unclamping)...
August 5, 2016: Transplantation
Francesca Cortellaro, Elisa Ceriani, Monica Spinelli, Carlo Campanella, Ilaria Bossi, Daniele Coen, Giovanni Casazza, Chiara Cogliati
Several studies address the accuracy of lung ultrasound (LUS) in the diagnosis of cardiogenic pulmonary edema (CPE) evaluating the interstitial syndrome, which is characterized by multiple and diffuse vertical artifacts (B-lines), and correlates with extravascular lung water. We studied the potential role of LUS in monitoring CPE response to therapy, by evaluating the clearance of interstitial syndrome within the first 24 h after Emergency Department (ED) admission. LUS was performed at arrival (T0), after 3 (T3) and 24 (T24) hours...
July 29, 2016: Internal and Emergency Medicine
A A Solodov, S S Petrikov, V V Krylov
Positive end-expiratory pressure is one of the main parameters of respiratory support influencing the gas exchange. However, despite the number ofpositive effects, PEEP can compromise venous outflow from the cranial cavity, increased intracranial pressure, decreased venous return and cardiac output and, consequently, reduced blood pressure and cerebral perfusion. The article presents the results of a survey of 39 patients with intracranial hemorrhage in critical state, undergoing respiratory support with different levels of positive end-expiratory pressure...
March 2016: Anesteziologiia i Reanimatologiia
Steven C Chase, Courtney M Wheatley, Lyle J Olson, Kenneth C Beck, Robert J Wentz, Eric M Snyder, Bryan J Taylor, Bruce D Johnson
Heart failure (HF) is often associated with pulmonary congestion, reduced lung function, abnormal gas exchange, and dyspnea. We tested whether pulmonary congestion is associated with expanded vascular beds or an actual increase in extravascular lung water (EVLW) and how airway caliber is affected in stable HF Subsequently we assessed the influence of an inhaled short acting beta agonist (SABA). Thirty-one HF (7F; age, 62 ± 11 years; ht. 175 ± 9 cm; wt. 91 ± 17 kg; LVEF, 28 ± 15%) and 29 controls (11F; age; 56 ± 11 years; ht...
July 2016: Physiological Reports
Claire Roger, Benjamin Louart, Guillaume Louart, Xavier Bobbia, Pierre-Geraud Claret, Antonia Perez-Martin, Laurent Muller, Jean-Yves Lefrant
OBJECTIVE: This study aimed to compare 2 fluid infusion rates of lactated Ringer (LR) and hydroxyethyl starch (HES) 130/0.4 on hemodynamic restoration at the early phase of controlled hemorrhagic shock. METHODS: Fifty-six anesthetized and ventilated piglets were bled until mean arterial pressure (MAP) reached 40 mm Hg. Controlled hemorrhage was maintained for 30 minutes. After this period, 4 resuscitation groups were studied (n=14 for each group): HES infused at 1 or 4mL/kg per minute or LR1 infused at 1 or 4mL/kg per minute until baseline MAP was restored...
September 2016: American Journal of Emergency Medicine
J-Q Li, N Li, G-J Han, C-G Pan, Y-H Zhang, X-Z Shi, J-Y Xu, B Lu, M-Q Li
OBJECTIVE: To evaluate clinical effects of airway pressure release ventilation (APRV) in patients suffering from moderate to severe acute respiratory distress syndrome (ARDS).e of a patient presented with significant high aminotransferase levels due to the first human R. aeschlimannii infection ever detected in Italy. The hypothesis of rickettsiosis was made on the basis of a comprehensive medical history and was confirmed by serological tests. Molecular analyses made on a sample of hepatic tissue revealed the presence of a rickettsial species never found before in human liver...
June 2016: European Review for Medical and Pharmacological Sciences
Paul Wurzer, Ludwik K Branski, Robert P Clayton, Gabriel Hundeshagen, Abigail A Forbes, Charles D Voigt, Clark R Andersen, Lars-P Kamolz, Lee C Woodson, Oscar E Suman, Celeste C Finnerty, David N Herndon
PURPOSE: The aim of this study was to quantify the effect of propranolol on hemodynamic parameters assessed using the PiCCO system in burned children. METHODS: We analyzed hemodynamic data from patients who were randomized to receive either propranolol (4 mg/kg/day) or placebo (control), which was initiated as a prospective randomized controlled trial. Endpoints were cardiac index (CI), percent predicted heart rate (%HR), mean arterial pressure (MAP), percent predicted stroke volume (%SV), rate pressure product (RPP), cardiac work (CW), systemic vascular resistance index (SVRI), extravascular lung water index (EVLWI), arterial blood gases, events of lactic acidosis, and mortality...
July 1, 2016: Shock
Kyriakos Anastasiadis, Polychronis Antonitsis, Konstantinos Vranis, Athanassios Kleontas, Christos Asteriou, Vassilios Grosomanidis, Paschalis Tossios, Helena Argiriadou
OBJECTIVES: Perioperative low cardiac output syndrome occurs in 3-14% of patients undergoing isolated coronary artery bypass grafting (CABG), leading to significant increase in major morbidity and mortality. Considering the unique pharmacological and pharmacokinetic properties of levosimendan, we conducted a prospective, double-blind, randomized pilot study to evaluate the effectiveness of prophylactic levosimendan in patients with impaired left ventricular function undergoing CABG. METHODS: Thirty-two patients undergoing CABG with low left ventricular ejection fraction (LVEF ≤ 40%) were randomized to receive either a continuous infusion of levosimendan at a dose of 0...
July 4, 2016: Interactive Cardiovascular and Thoracic Surgery
S A Komarov, M Y Kirov
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Bingdong Tao, Lidan Liu, Ni Wang, Wei Wang, Jingjing Jiang, Jin Zhang
Aquaporin 1(AQP1) and AQP5 have an important role in eliminating extravascular lung water, an increase of which contributes to lung injury in patients with sepsis and its consequent mortality. It has been reported that hydrogen-rich saline (HRS) has protective effects against sepsis-related lung injury. In this study, we hypothesized that the protective effect occurred by preserving the expression of AQP1 and AQP5. To test this hypothesis, male Sprague-Dawley rats received intratracheal administration of lipopolysaccharide (LPS) followed by intraperitoneal injection of HRS...
May 15, 2016: Journal of Surgical Research
Hua-dong Zhu, Liang-liang Zheng, Chen Li, Dong-qi Yao, Ji-hai Liu, Tie-kuan Du, Xue-zhong Yu, Jun Xu
OBJECTIVE: To investigate the effect of atrial fibrillation on the accuracy of parameters monitored by transpulmonary thermodilution method. METHODS: Totally 12 patients from emergency intensive care unit with paroxysmal atrial fibrillation were enrolled. The hemodynamic parameters such as heart rate, mean arterial pressure, cardiac index, systemic vascular resistance index, intrathoracic blood volume index, and extravascular lung water index were monitored by transpulmonary thermodilution method before paroxysmal atrial fibrillation and during atrial fibrillation, the number of B-lines was detected by lung ultrasonography before and during paroxysmal atrial fibrillation...
April 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Eugenio Picano, Patricia A Pellikka
Extravascular lung water (EVLW) is a key variable in heart failure management and prognosis, but its objective assessment remains elusive. Lung imaging has been traditionally considered off-limits for ultrasound techniques due to the acoustic barrier of high-impedance air wall. In pulmonary congestion however, the presence of both air and water creates a peculiar echo fingerprint. Lung ultrasound shows B-lines, comet-like signals arising from a hyper-echoic pleural line with a to-and-fro movement synchronized with respiration...
July 14, 2016: European Heart Journal
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