• Journal of critical care · Apr 2018

    Observational Study

    Inflammatory lung edema correlates with echocardiographic estimation of capillary wedge pressure in newly diagnosed septic patients.

    • Thiago M Santos, Daniel Franci, Carolina M Gontijo-Coutinho, Tatiana Mirabetti Ozahata, Tiago de Araújo Guerra Grangeia, José R Matos-Souza, and Marco A Carvalho-Filho.
    • Discipline of Emergency Medicine, Hospital of the University of Campinas (Unicamp), 126 Tessália Vieira de Camargo St., Cidade Universitária "Zeferino Vaz", Postal Code 13083-887 Campinas, SP, Brazil. Electronic address: santosth@unicamp.br.
    • J Crit Care. 2018 Apr 1; 44: 392-397.

    PurposeLung ultrasound is an accurate and accessible tool to quantify lung edema. Furthermore, left ventricle filling pressures (LVFP) can be assessed with transthoracic echocardiography (TTE) by the E/e' ratio (E/e'). The present study aimed to assess the correlation between E/e' and lung edema quantified by a simplified lung ultrasound score (LUS) in newly admitted septic patients.Materials And MethodsIn this prospective observational cohort, septic adult patients admitted at the emergency department of a tertiary hospital were included. LUS consisted of four different patterns of lung edema (from normal aeration to parenchymal consolidation). To compare lung edema with LVFP, E/e' was calculated immediately before or within 5min of fluid therapy.ResultsFifty patients were enrolled in 3months. The LUS correlated with E/e' (r=0.58, P<0.0001). The LUS also increased among E/e' quartiles (Q) (Q1: E/e'≤4.49; Q2: 4.497.11; P=0.0003 for Q1 and 4; 2 and 4); and LUS was significantly higher in abnormal (≥8) vs. normal (<8) values of E/e' (11.29 vs 8.49, P=0.007).ConclusionIn newly admitted septic patients, lung edema is positively correlated with LVFP prior to fluid therapy. This finding might help find future targets for fluid resuscitation in sepsis.Copyright © 2017 Elsevier Inc. All rights reserved.

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