Assessing Extravascular Lung Water in Critically Ill Patients Using Lung Ultrasound: A Systematic Review on Methodological Aspects in Diagnostic Accuracy Studies

2020 ◽  
Vol 46 (7) ◽  
pp. 1557-1564 ◽  
Author(s):  
Owen B. Neuteboom ◽  
Micah L. Heldeweg ◽  
Luigi Pisani ◽  
Marry R. Smit ◽  
Wim K. Lagrand ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Extravascular Lung Water ◽  
Lung Ultrasound ◽  
Lung Water ◽  
Methodological Aspects

scholarly journals B-Lines Scores Derived From Lung Ultrasound Provide Accurate Prediction of Extravascular Lung Water Index: An Observational Study in Critically Ill Patients

2020 ◽  
pp. 088506662096765 ◽  
Author(s):  
Ulrich Mayr ◽  
Marina Lukas ◽  
Livia Habenicht ◽  
Johannes Wiessner ◽  
Markus Heilmaier ◽  
...  
Keyword(s):  
Pulmonary Edema ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Extravascular Lung Water ◽  
Lung Ultrasound ◽  
Lung Water ◽  
Extravascular Lung Water Index ◽  
Water Index ◽  
Non Invasive ◽  
B Lines

Introduction: Visualization of B-lines via lung ultrasound provides a non-invasive estimation of pulmonary hydration. Extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI) assessed by transpulmonary thermodilution (TPTD) represent the most validated parameters of lung water and alveolocapillary permeability, but measurement is invasive and expensive. This study aimed to compare the correlations of B-lines scores from extensive 28-sector and simplified 4-sector chest scan with EVLWI and PVPI derived from TPTD in the setting of intensive care unit (primary endpoint). Methods: We performed scoring of 28-sector and 4-sector B-Lines in 50 critically ill patients. TPTD was carried out with the PiCCO-2-device (Pulsion Medical Systems SE, Maquet Getinge Group). Median time exposure for ultrasound procedure was 12 minutes for 28-sector and 4 minutes for 4-sector scan. Results: Primarily, we found close correlations of 28-sector as well as 4-sector B-Lines scores with EVLWI (R2 = 0.895 vs. R2 = 0.880) and PVPI (R2 = 0.760 vs. R2 = 0.742). Both B-lines scores showed high accuracy to identify patients with specific levels of EVLWI and PVPI. The extensive 28-sector B-lines score revealed a moderate advantage compared to simplified 4-sector scan in detecting a normal EVLWI ≤ 7 (28-sector scan: sensitivity = 81.8%, specificity = 94.9%, AUC = 0.939 versus 4-sector scan: sensitivity = 81.8%, specificity = 82.1%, AUC = 0.902). Both protocols were approximately equivalent in prediction of lung edema with EVLWI ≥ 10 (28-sector scan: sensitivity = 88.9%, specificity = 95.7%, AUC = 0.977 versus 4-sector scan: sensitivity = 81.5%, specificity = 91.3%, AUC = 0.958) or severe pulmonary edema with EVLWI ≥ 15 (28-sector scan: sensitivity = 91.7%, specificity = 97.4%, AUC = 0.995 versus 4-sector scan: sensitivity = 91.7%, specificity = 92.1%, AUC = 0.978). As secondary endpoints, our evaluations resulted in significant associations of 28-sector as well as simplified 4-sector B-Lines score with parameters of respiratory function. Conclusion: Both B-line protocols provide accurate non-invasive evaluation of lung water in critically ill patients. The 28-sector scan offers a marginal advantage in prediction of pulmonary edema, but needs substantially more time than 4-sector scan.

scholarly journals Fluid management in critically ill patients: the role of extravascular lung water, abdominal hypertension, capillary leak, and fluid balance

2012 ◽  
Vol 2 (Suppl 1) ◽  
pp. S1 ◽  
Author(s):  
Colin Cordemans ◽  
Inneke De laet ◽  
Niels Van Regenmortel ◽  
Karen Schoonheydt ◽  
Hilde Dits ◽  
...  
Keyword(s):  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Extravascular Lung Water ◽  
Fluid Management ◽  
Capillary Leak ◽  
Lung Water ◽  
Abdominal Hypertension

Bedside estimation of extravascular lung water in critically ill patients: comparison of the chest radiograph and the thermal dye technique

1984 ◽  
Vol 10 (6) ◽  
pp. 309-313 ◽  
Author(s):  
A. Laggner ◽  
G. Kleinberger ◽  
J. Haller ◽  
K. Lenz ◽  
G. Sommer ◽  
...  
Keyword(s):  
Critically Ill ◽  
Chest Radiograph ◽  
Critically Ill Patients ◽  
Extravascular Lung Water ◽  
Lung Water

Real-world extravascular lung water index measurements in critically ill patients

2019 ◽  
Vol 131 (13-14) ◽  
pp. 321-328 ◽  
Author(s):  
Matthias Werner ◽  
Bernhard Wernly ◽  
Michael Lichtenauer ◽  
Marcus Franz ◽  
Bjoern Kabisch ◽  
...  
Keyword(s):  
Critically Ill ◽  
Real World ◽  
Critically Ill Patients ◽  
Extravascular Lung Water ◽  
Lung Water ◽  
Extravascular Lung Water Index ◽  
Water Index

Prognostic Value of Extravascular Lung Water in Critically Ill Patients

CHEST Journal ◽  
2002 ◽  
Vol 122 (6) ◽  
pp. 2080-2086 ◽  
Author(s):  
Samir G. Sakka ◽  
Magdalena Klein ◽  
Konrad Reinhart ◽  
Andreas Meier-Hellmann
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Extravascular Lung Water ◽  
Prognostic Value ◽  
Lung Water
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