Skip to main content

Is there a role of extravascular lung water (EVLW) in the development of atelectasis in ARDS?


To evaluate the relationship between PaO2/FiO2 ratio and EVLW in septic shock induced ARDS in a prospective observational clinical trial.

Materials and methods

Twenty-three patients suffering from sepsis-induced ARDS were recruited. All patients were ventilated in pressure control/support mode. Haemodynamic parameters were determined by arterial thermodilution (PiCCO) 8 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 EVLW and PaO2/FiO2 (r = -0.355, P < 0.001), and significant positive correlation was shown between EVLW and PEEP (r = 0.557, P < 0.001). A post-hoc analysis was also performed when 'low' PEEP (< 10 cmH2O) and 'high' PEEP (≥ 10 cmH2O) were applied (Table 1).

Table 1


Several animal trials reported contradicting results on the effect of PEEP on EVLW [1]. We found significant correlation between EVLW and PaO2/FiO2 and PEEP. Furthermore, patients with increase EVLW required higher PEEP, while none of the other parameters differed significantly when 'high' or 'low' PEEP were applied. Based on the current results we assume that it is the EVLW that indirectly determines the required PEEP by playing a part in the development of alveolar atelectasis. Further studies are required to evaluate the clinical significance of this finding, for example in the fine-tuning of PEEP in ARDS.


  1. Ruiz-Bailen M, Fernandez-Mondejar E, Hurtado-Ruiz B, et al.: Crit Care Med 1999, 27: 380-384. 10.1097/00003246-199902000-00046

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Reprints and Permissions

About this article

Cite this article

Szakmány, T., Molnár, Z. & Heigl, P. Is there a role of extravascular lung water (EVLW) in the development of atelectasis in ARDS?. Crit Care 7 (Suppl 2), P187 (2003).

Download citation

  • Published:

  • DOI:


  • Septic Shock
  • Significant Positive Correlation
  • Significant Negative Correlation
  • Correlation Test
  • Respiratory Parameter