Extravascular lung water and pulmonary arterial wedge pressure for fluid management in patients with acute respiratory distress syndrome

Wei Hu; Chang-Wen Lin; Bing-Wei Liu; Wei-Hang Hu; Ying Zhu

doi:10.4081/mrm.2014.360

Extravascular lung water and pulmonary arterial wedge pressure for fluid management in patients with acute respiratory distress syndrome

Authors

Wei Hu Department of Intensive Care Unit, the First People’s Hospital of Hangzhou, Nanjing Medical University, Hangzhou
Chang-Wen Lin Department of Intensive Care Unit, the First People’s Hospital of Hangzhou, Nanjing Medical University, Hangzhou
Bing-Wei Liu Department of Intensive Care Unit, the First People’s Hospital of Hangzhou, Nanjing Medical University, Hangzhou
Wei-Hang Hu Department of Intensive Care Unit, the First People’s Hospital of Hangzhou, Nanjing Medical University, Hangzhou
Ying Zhu Department of Intensive Care Unit, the First People’s Hospital of Hangzhou, Nanjing Medical University, Hangzhou

DOI: https://doi.org/10.4081/mrm.2014.360

Keywords:

Acute respiratory distress syndrome, Extravascular lung water, Fluid management, Pulmonary artery wedge pressure

Abstract

Background: Extravascular lung water (EVLW) is a sensitive prognostic indicator of pulmonary edema. Thus, EVLW may be an advantageous method of fluid management. This study aims to evaluate the outcomes of using EVLW and pulmonary artery wedge pressure (PAWP) as strategies for fluid management in patients with acute respiratory distress syndrome (ARDS).

Methods: Twenty-nine patients were randomly divided into the EVLW and PAWP groups. The survival rate, ICU (Intensive Care Unit) length of stay, duration of mechanical ventilation, acute lung injury scores, and oxygenation index of the EVLW and PAWP groups were compared.

Results: No significant difference in the survival rates at 28 and 60 days (d) after treatment was found between the two groups (p = 0.542). The duration of mechanical ventilation and ICU length of stay were significantly lower (p<0.05) in the EVLW group than in the PAWP group. The 7 d cumulative fluid balance was −783 ± 391 ml in the EVLW group and −256 ± 514 ml in the PAWP group (p < 0.05). Compared with the PAWP group, the EVLW group showed improved oxygenation index (p = 0.006).

Conclusions: EVLW for fluid management improved clinical results in patients with ARDS better than PAWP.