Assessment of extravascular lung water and pulmonary vascular permeability evaluated by the pulse contour cardiac output in systemic inflammatory response syndrome patients

Introduction

Pulse contour cardiac output (PiCCO) provides an estimate of the intrathoracic blood volume (ITBV), extravascular lung water (EVLW), and pulmonary vascular permeability index (PVPI). Few investigations have prospectively examined EVLW in patients with severe sepsis or ARDS.

Objective

The aim of this study was compare measurements of ITBV, EVLW, and PVPI in systemic inflammatory response syndrome (SIRS) patients.

Materials and methods

Twenty-eight adult patients with SIRS admitted to our ICU were studied in three groups. Group A, nine patients with pneumonia; group B, nine patients with extrathoracic infection; group C, 10 patients without infection were enrolled. In each patient, PiCCO was used to measure the ITBV and EVLW for 3 days of meeting criteria for SIRS. The PVPI was calculated as the ratio of EVLW to ITBV. EVLW values were indexed by the predicted body weight and ITBV values were indexed by the predicted body surface. All data are presented as mean ± standard deviation. The Kruskal–Wallis H test was performed for statistical analysis and P < 0.05 was considered statistically significant.

Results

See Table 1. One hundred and forty samples of data were collected. The mean PVPI value was within the normal range. The EVLWI and PVPI were significantly higher in group A than in group B. The EVLWI and PVPI were significantly higher in group B than in group C too.

Table 1 (abstract P286)

Conclusion

Our data indicate that the permeability of pulmonary vessels is increased more with infection than without infection, and is also higher with pneumonia than with extrathoracic infection in SIRS patients.