NDLI: Acute lung injury, overhydration or both?

Content Provider	Springer Nature : BioMed Central
Author	Groeneveld, AB Johan Polderman, Kees H
Abstract	Acute lung injury or acute respiratory distress syndrome (ALI/ARDS) in the course of sepsis is thought to result from increased pulmonary capillary permeability and resultant edema. However, when the edema is assessed at the bedside by measuring the extravascular thermal volume by transpulmonary dilution, some ALI/ARDS patients with sepsis may have normal extravascular lung water (EVLW). Conversely, a raised EVLW may be present even when criteria for ALI/ARDS are not met, according to GS Martin and colleagues in this issue of Critical Care. This commentary puts the findings into a broader perspective and focuses on the difficulty, at the bedside, in recognizing and separating various types of pulmonary edema. Some of these forms of edema, classically differentiated on the basis of increased permeability and cardiogenic/hydrostatic factors, may overlap, whereas the criteria for ALI/ARDS may be loose, poorly reproducible, relatively insensitive and nonspecific, and highly therapy-dependent. Overhydration is particularly difficult to recognize. Additional diagnostics may be required to improve the delineation of pulmonary edema so as to redirect or redefine treatment and improve patient morbidity and, perhaps, mortality. Monitoring EVLW by single transpulmonary thermal dilution, for instance, might have a future role in this process.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc3039.pdf
Ending Page	2
Page Count	2
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc3039
Journal	Critical Care
Issue Number	2
Volume Number	9
Language	English
Publisher	BioMed Central
Publisher Date	2005-01-17
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Acute Lung Injury Pulmonary Capillary Wedge Pressure Extravascular Lung Water Transpulmonary Thermodilution Positive Fluid Balance
Content Type	Text
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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