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J Clin Monit Comput ; 33(1): 5-12, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-29680878

RESUMEN

Extravascular lung water (index) (EVLW(I)) can be estimated using transpulmonary thermodilution (TPTD). Computed tomography (CT) with quantitative analysis of lung tissue density has been proposed to quantify pulmonary edema. We compared variables of pulmonary fluid status assessed using quantitative CT and TPTD in critically ill patients. In 21 intensive care unit patients, we performed TPTD measurements directly before and after chest CT. Based on the density data of segmented CT images we calculated the tissue volume (TV), tissue volume index (TVI), and the mean weighted index of voxel aqueous density (VMWaq). CT-derived TV, TVI, and VMWaq did not predict TPTD-derived EVLWI values ≥ 14 mL/kg. There was a significant moderate positive correlation between VMWaq and mean EVLWI (EVLWI before and after CT) (r = 0.45, p = 0.042) and EVLWI after CT (r = 0.49, p = 0.025) but not EVLWI before CT (r = 0.38, p = 0.086). There was no significant correlation between TV and EVLW before CT, EVLW after CT, or mean EVLW. There was no significant correlation between TVI and EVLWI before CT, EVLWI after CT, or mean EVLWI. CT-derived variables did not predict elevated TPTD-derived EVLWI values. In unselected critically ill patients, variables of pulmonary fluid status assessed using quantitative CT cannot be used to predict EVLWI.


Asunto(s)
Enfermedad Crítica , Agua Pulmonar Extravascular/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Edema Pulmonar/diagnóstico por imagen , Termodilución/métodos , Anciano , Cuidados Críticos , Femenino , Hemodinámica , Humanos , Unidades de Cuidados Intensivos , Pulmón/irrigación sanguínea , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X
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