• Martin Kutej, Jiri Sagan, Tereza Ekrtova, Hana Strakova, Marek Buzga, Michal Burda, and Jan Maca.
• Department of Anaesthesiology and Intensive Care Medicine, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
• Respir Care. 2024 Jul 23.

BackgroundThe dominant feature of COVID-19-associated ARDS is gas exchange impairment. Extravascular lung water index is a surrogate for lung edema and reflects the level of alveolocapillary disruption. The primary aim was the prediction of extravascular lung water index by the alveolar-arterial oxygen difference. The secondary aims were in determining the relationship between the extravascular lung water index and other oxygenation parameters, the FIO2 , end-tidal oxygen concentration, pulmonary oxygen gradient (FIO2 minus end-tidal oxygen concentration), and PaO2 .MethodsThis observational prospective single-center study was performed at the Department of Anaesthesiology and Intensive Care, The University Hospital in Ostrava, The Czech Republic, during the COVID-19 pandemic, from March 20, 2020, until May 24, 2021.ResultsThe relationship between the extravascular lung water index and alveolar-arterial oxygen difference showed only a mild-to-moderate correlation (r = 0.33, P < .001). Other extravascular lung water index correlations were as follows: FIO2 (r = 0.33, P < .001), end-tidal oxygen concentration (r = 0.26, P = .0032), FIO2 minus end-tidal oxygen concentration (r = 0.15, P = .0624), and PaO2 (r = -0.15, P = .01).ConclusionsThe alveolar-arterial oxygen difference does not reliably correlate with the extravascular lung water index and the degree of lung edema in COVID-19-associated ARDS.Copyright © 2024 by Daedalus Enterprises.

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