Comparison of lung ultrasound with transpulmonary thermodilution in assessing extra-vascular lung water

Authors

  • Jody Gerschon Davids University of the Free State
  • Edwin W Turton University of the Free State
  • Jacques Eugene Raubenheimer University of the Free State

Keywords:

extra-vascular lung water, lung ultrasound, critical care, thermodilution, B-lines

Abstract

Background: Increased extra-vascular lung water (EVLW) is common in critical care and correlates with the severity of acute lung injury, length of intensive care unit stay and mortality. Lung ultrasound (LUS) can assess EVLW by determining the amount of ‘B-lines’: artefacts signifying alveolar-interstitial oedema. This study’s aim was to determine whether EVLW estimation with the help of LUS correlates with the more accurate PiCCO2® cardiac output system utilising transpulmonary thermodilution. Methods: This prospective observational study was undertaken at Universitas Academic Hospital, Bloemfontein. Patients were scanned according to a fixed protocol, followed by transpulmonary thermodilution. The cumulative B-line count was compared with the EVLW index generated by the PiCCO2® system. Results: Four males and six females were enrolled. The mean EVLW index was 9.1 ml/kg/m2 (standard deviation 1.45), and the median cumulative B-line count was 14 (interquartile range 6–25). A positive, but not statistically significant, correlation was found (r = 0.40, p = 0.25) between the B-line count and EVLW index. Conclusion: This study investigated a possible correlation between LUS interpretation and transpulmonary thermodilution in assessing EVLW. Results seem promising, but the small sample could indicate only that LUS might be of use for the assessment of EVLW. Further studies are needed. (Full text available online at www.medpharm.tandfonline.com/ojaa) South Afr J Anaesth Analg 2016; DOI: 10.1080/22201181.2016.1216663

Author Biographies

Jody Gerschon Davids, University of the Free State

Consultant Anaesthesiologist Faculty of Health Sciences Department of Anaesthesiology University of the Free State; and Department of Anaesthesiology George Regional Hospital George

Edwin W Turton, University of the Free State

Faculty of Health Sciences Department of Anaesthesiology University of the Free State

Jacques Eugene Raubenheimer, University of the Free State

Faculty of Health Sciences Department of Biostatistics University of the Free State

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Published

2016-11-30

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Section

Research Articles