Pulmonary permeability index predicts progression to acute lung injury in patients with increased risk

Cr Phillips,K Bacon,J Pinney,Jl Letourneau,A Nielsen

doi:10.1186/cc7213

Abstract

Early identification of progression to acute lung injury (ALI) in patients at risk may change therapy and potentially improve outcome. Central to the pathogenesis of ALI is pulmonary microvascular injury and increased permeability resulting in pulmonary edema. We proposed that the pulmonary vascular permeability index (PVPI) (extravascular lung water (EVLW) (ml)/pulmonary blood volume (PBV) (ml)) reflects the severity of this injury and predicts progression to ALI in patients at risk.

Highlights

There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient’s experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients
Hour survival: 81% vs. 41%; adjusted: operating room (OR) = 19.8, 95% cardiac index (CI) = 3.1 to 72.6, P
Results of this study show that early tracheostomy, if perioperative complications

Summary

Introduction

There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient’s experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients. Conclusions Our data demonstrate that critically ill patients may be exposed to a higher FiO2 than that required to maintain adequate oxygenation These results highlight an area of ICU care that has received little study, with no published clinical trials examining the effect of FiO2 on outcome. Results Age, sex, the underlying disease and tumour stage (TNM classification), type of previous anticancer treatment, performance status, severity scores (APACHE II, Simplified Acute Physiology Score II, Sequential Organ Failure Assessment), ICU and hospital mortalities and hospital outcome at 3, 6 and 12 months were analysed. Clinical data of 277 post-transplantation patients admitted to the ICU were collected at admission and the SAPS 3 and APACHE II score calculated with respective estimated mortality rates.

Objectives

Methods

Results

Conclusion