• Takeshi Yagi, Tadashi Kaneko, Ryosuke Tsuruta, Shunji Kasaoka, Takashi Miyauchi, Motoki Fujita, Yoshikatsu Kawamura, Samir G Sakka, and Tsuyoshi Maekawa.
• Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 755-8505, Japan.
• J Crit Care. 2011 Apr 1;26(2):224.e9-13.

BackgroundThe transpulmonary thermodilution technique allows the determination of cardiac preload (global end-diastolic volume index) and quantification of pulmonary edema (extravascular lung water index [EVLWI]). Pulmonary edema commonly develops in critically ill patients; however, the underlying pathophysiology, that is, hydrostatic (cardiac) or permeability-induced (noncardiac), often remains unclear. In this study, hemodynamic and serum parameters of osmolarity and oncotic pressure were analyzed to identify risk factors for increased EVLWI.MethodsA retrospective, single-center analysis in an intensive care unit of a university hospital was performed. No interventions were made for the study. Forty-two critically ill patients were included, and 126 simultaneous hemodynamic measurements and serum determinations were analyzed by logistic regression and Spearman rank correlation coefficient analysis.ResultsGlobal end-diastolic volume index (P = .001), serum albumin (P = .006), and serum osmolarity (P = .029) were significant factors for increased EVLWI (defined as >10 mL/kg).ConclusionHypervolemia, hypoalbuminemia, and high plasma osmolarity are associated with increased EVLWI.Copyright © 2011 Elsevier Inc. All rights reserved.

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