Comparison of a single indicator and gravimetric technique for estimation of extravascular lung water in endotoxemic pigs
| Autor: | Anders Oldner, Anders Rudehill, Eddie Weitzberg, Patrik Rossi, Michael Wanecek, David Konrad |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Lipopolysaccharides
Male Pulmonary Circulation Swine medicine.medical_treatment Thermodilution Pulmonary Edema Blood volume Critical Care and Intensive Care Medicine Ventilation/perfusion ratio Sepsis Intensive care medicine Intravascular volume status Animals Analysis of Variance Respiratory Distress Syndrome Blood Volume business.industry Pulmonary artery catheter respiratory system Pulmonary edema medicine.disease Anesthesia Extravascular Lung Water Breathing Female Pulmonary Ventilation business Perfusion |
| Zdroj: | Critical Care Medicine. 34:1437-1443 |
| ISSN: | 0090-3493 |
| DOI: | 10.1097/01.ccm.0000215830.48977.29 |
| Popis: | Objectives To compare the single thermal indicator dilution (STID) technique for measurement of extravascular lung water (EVLW(STID)) with gravimetrically determined EVLW (EVLW(GRAV)) in anesthetized pigs under sham and endotoxemic conditions. Design Open experimental comparative animal study. Setting University animal research laboratory. Subjects Fifteen anesthetized landrace pigs. Interventions Endotoxin infusion during 5 hrs in five pigs. Six animals were only anesthetized and rested for 5 hrs. In four additional animals, the impact on EVLW(STID) measurements by changes in pulmonary perfusion, ventilation, and the combination of the two was studied. The alterations in ventilation and perfusion were induced by caval balloon inflation, inflation of the pulmonary artery catheter balloon, and bronchial plugging respectively. Measurements and main results The STID technique, with default settings of the intrathoracic blood volume (ITBV) to global end-diastolic volume (GEDV) (i.e., the extrapulmonary intravascular volume between the point of injection of the indicator, and the point of detection) relationship (ITBV = 1.25GEDV), systematically overestimated the EVLW index compared with the gravimetrical method (mean bias of 5.4 mL/kg). By adapting the ITBV to GEDV relationship to the current model (ITBV = 1.52GEDV + 49.7), the accuracy of the STID technique improved. Moreover, the measurement of EVLW(STID) proved to be reduced by manipulation of pulmonary perfusion and ventilation. However, the STID technique could detect an increase in EVLW during endotoxemia independent of the ITBV/GEDV relationship used. Conclusion Despite technological improvement, the dilution techniques for the measurement of EVLW might still be influenced by changes in perfusion and ventilation. The STID technique, in addition, might demand adjustment of the ITBV/GEDV relationship to the particular condition and species subjected to measurement. The STID technique may, however, be a useful tool for monitoring changes of EVLW over time, but further studies are warranted to confirm this. |
| Databáze: | OpenAIRE |
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