Correlation between extravascular lung water and oxygenation in ALI/ARDS patients in septic shock

Possible role in the development of atelectasis?

T. Szakmany, P. Heigl, Z. Molnár

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

This study aimed to evaluate the relationship between PaO2/FiO2 ratio and extravascular lung water in septic shock-induced acute respiratory distress syndrome in a prospective observational clinical trial. Twenty-three patients suffering from sepsis induced acute respiratory distress syndrome were recruited. All patients were ventilated in pressure control/support mode. Haemodynamic parameters were determined by arterial thermodilution (PiCCO) eight hourly for 72 hours. At the same time blood gas analyses were done and respiratory parameters were also recorded. Data are presented as mean±SD. For statistical analysis Pearson's correlation test, and analysis of variance (ANOVA) was used respectively. Significant negative correlation was found between extravascular lung water and PaO2/FiO2 (r=-0.355, P2O and "high" PEEP: (10 cmH2O PEEP was applied, and neither the oxygenation, nor the driving pressure or the PaCO2 differed significantly, but the extravascular lung water showed significant difference when "high" or "low" PEEP was applied (13±5 vs 9±2 ml/kg respectively, P=0.001). This study found significant negative correlation between extravascular lung water and P aO2/FiO2. The mechanism by which extravascular lung water affects oxygenation is unknown but the significant positive correlation between PEEP and extravascular lung water shown in this trial suggests that the latter may have a role in the development of alveolar atelectasis.

Original languageEnglish
Pages (from-to)196-201
Number of pages6
JournalAnaesthesia and Intensive Care
Volume32
Issue number2
Publication statusPublished - Apr 2004

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Extravascular Lung Water
Pulmonary Atelectasis
Septic Shock
Adult Respiratory Distress Syndrome
Pressure
Thermodilution
Blood Gas Analysis
Sepsis
Analysis of Variance
Hemodynamics
Clinical Trials

Keywords

  • Extravascular lung water
  • Positive end expiratory pressure
  • Positive pressure respiration
  • Pulmonary oedema
  • Septic
  • Shock

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

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title = "Correlation between extravascular lung water and oxygenation in ALI/ARDS patients in septic shock: Possible role in the development of atelectasis?",
abstract = "This study aimed to evaluate the relationship between PaO2/FiO2 ratio and extravascular lung water in septic shock-induced acute respiratory distress syndrome in a prospective observational clinical trial. Twenty-three patients suffering from sepsis induced acute respiratory distress syndrome were recruited. All patients were ventilated in pressure control/support mode. Haemodynamic parameters were determined by arterial thermodilution (PiCCO) eight hourly for 72 hours. At the same time blood gas analyses were done and respiratory parameters were also recorded. Data are presented as mean±SD. For statistical analysis Pearson's correlation test, and analysis of variance (ANOVA) was used respectively. Significant negative correlation was found between extravascular lung water and PaO2/FiO2 (r=-0.355, P2O and {"}high{"} PEEP: (10 cmH2O PEEP was applied, and neither the oxygenation, nor the driving pressure or the PaCO2 differed significantly, but the extravascular lung water showed significant difference when {"}high{"} or {"}low{"} PEEP was applied (13±5 vs 9±2 ml/kg respectively, P=0.001). This study found significant negative correlation between extravascular lung water and P aO2/FiO2. The mechanism by which extravascular lung water affects oxygenation is unknown but the significant positive correlation between PEEP and extravascular lung water shown in this trial suggests that the latter may have a role in the development of alveolar atelectasis.",
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N2 - This study aimed to evaluate the relationship between PaO2/FiO2 ratio and extravascular lung water in septic shock-induced acute respiratory distress syndrome in a prospective observational clinical trial. Twenty-three patients suffering from sepsis induced acute respiratory distress syndrome were recruited. All patients were ventilated in pressure control/support mode. Haemodynamic parameters were determined by arterial thermodilution (PiCCO) eight hourly for 72 hours. At the same time blood gas analyses were done and respiratory parameters were also recorded. Data are presented as mean±SD. For statistical analysis Pearson's correlation test, and analysis of variance (ANOVA) was used respectively. Significant negative correlation was found between extravascular lung water and PaO2/FiO2 (r=-0.355, P2O and "high" PEEP: (10 cmH2O PEEP was applied, and neither the oxygenation, nor the driving pressure or the PaCO2 differed significantly, but the extravascular lung water showed significant difference when "high" or "low" PEEP was applied (13±5 vs 9±2 ml/kg respectively, P=0.001). This study found significant negative correlation between extravascular lung water and P aO2/FiO2. The mechanism by which extravascular lung water affects oxygenation is unknown but the significant positive correlation between PEEP and extravascular lung water shown in this trial suggests that the latter may have a role in the development of alveolar atelectasis.

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