Quantitative computed tomography in comparison with transpulmonary thermodilution for the estimation of pulmonary fluid status: a clinical study in critically ill patients
| Autor: | Albrecht Staudt, Roland M. Schmid, Vsevolod V. Kuzkov, Bernd Saugel, Moritz Wildgruber, Wolfgang Huber, Konstantin Holzapfel, Michael Dieckmeyer, Mikhail Y. Kirov, Georgios Kaissis |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Critical Care Critical Illness Thermodilution Pulmonary Edema Health Informatics Critical Care and Intensive Care Medicine Positive correlation Clinical study 03 medical and health sciences 0302 clinical medicine medicine Humans Quantitative computed tomography Lung Aged medicine.diagnostic_test Critically ill business.industry Hemodynamics 030208 emergency & critical care medicine Middle Aged Pulmonary edema medicine.disease Intensive Care Units Anesthesiology and Pain Medicine Lung water 030228 respiratory system Extravascular Lung Water Stock price index Female Tomography X-Ray Computed Nuclear medicine business Tissue volume |
| Zdroj: | Journal of Clinical Monitoring and Computing. 33:5-12 |
| ISSN: | 1573-2614 1387-1307 |
| DOI: | 10.1007/s10877-018-0144-1 |
| Popis: | 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). CT-derived TV, TVI, and VMWaq did not predict TPTD-derived EVLWI values ≥ 14 mL/kg. There was a significant moderate positive correlation between VMWaq and mean EVLWI (EVLWI before and after CT) (r = 0.45, p = 0.042) and EVLWI after CT (r = 0.49, p = 0.025) but not EVLWI before CT (r = 0.38, p = 0.086). There was no significant correlation between TV and EVLW before CT, EVLW after CT, or mean EVLW. There was no significant correlation between TVI and EVLWI before CT, EVLWI after CT, or mean EVLWI. CT-derived variables did not predict elevated TPTD-derived EVLWI values. In unselected critically ill patients, variables of pulmonary fluid status assessed using quantitative CT cannot be used to predict EVLWI. |
| Databáze: | OpenAIRE |
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