Intrathoracic blood volume index and extravascular lung water index in septic shock patients

Introduction

We analyzed the intrathoracic blood volume index (ITBVI) and the pulmonary artery occlusion pressure (PAOP) with respect to the stroke volume index (SVI) as the preload index. The extravascular lung water index with respect to the PaO₂/FiO₂ ratio was also analyzed.

Methods

We prospectively studied 10 patients with septic shock monitored with a pulmonary artery catheter and the COLD System (COLD-Z021 Pulsion Medical System, Munich, Germany). Measurements were performed every 8 hours from the study admission until 48 hours. The relationships between variables were analyzed by linear regression.

Results

Linear regression between ITBVI/SVI was r² = 0.30 (P < 0.0001) while the PAOP failed to correlate (r² = 0.03) (Fig. 1). The ELVWI showed a significant correlation with PaO₂/FiO₂ (r² = -0.23, P < 0.0001) (Fig. 2).

Figure 1

Figure 2

Conclusions

Our results showed that ITBVI is a more reliable indicator than PAOP for preload assessment in septic shock patients. EVLWI confirmed to be a very interesting bedside lung edema index in this selected population.