Chest
Clinical InvestigationsEvaluation of the Portable Chest Roentgenogram for Quantitating Extravascular Lung Water in Critically Ill Adults
Section snippets
Materials and Methods
TWelve patients admitted to the intensive care unit with a diagnosis of respiratory failure were studied. All patients were intubated and mechanically ventilated at the time of entry into this study. The study was approved by the Stanford University Human Subjects Committee, and informed consent was obtained. A 16 ga central venous catheter or a 7F triple-lumen pulmonary artery catheter (Edwards Laboratory model 93A) was placed via the right internal jugular vein using a modified Seldinger
Results
Measurements of extravascular lung water (n=73) were compared with portable chest radiographic scores in 12 patients who were supine at the time of filming (Table 1). Chest roentgenograms were monitored and measurements of extravascular lung water were taken for two to six days for each patient. Extravascular lung water measured from 3.9 ml/kg to 44 ml/kg. Portable chest radiograph scores ranged from 120 points to 390 points. The average change in lung water was 2.2 ml/kg between successive
Discussion
This study sought to evaluate the accuracy of portable chest roentgenograms as a readily obtainable noninvasive monitor of extravascular lung water. The accuracy of the technique for measurement of lung water and the reliability of the radiographic scoring system was critical for this analysis. For the purpose of this study, careful attention was paid to a consistent quality of the portable chest roentgenograms, so that the radiographic technique would not interfere with the evaluation of any
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Cited by (125)
Noninvasive Imaging Methods for Quantification of Pulmonary Edema and Congestion: A Systematic Review
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2021, Advances in Chronic Kidney DiseaseCitation Excerpt :CXR is also of limited value in the determination of intravascular volume. Multiple studies have confirmed that typical radiographic findings thought to be suggestive of volume overload are not actually predictive and that CXR findings do not predict extravascular lung water volumes.30–33 CVP and PAOP were once thought to be accurate measures of intravascular volume; however, both measurements have fallen out of favor.
Inflammatory lung edema correlates with echocardiographic estimation of capillary wedge pressure in newly diagnosed septic patients
2018, Journal of Critical CareCitation Excerpt :Moreover, optimal radiographic technique ideally requires the upright position, which is often impossible with most critically ill patients. These patients usually have other lung abnormalities that might hinder chest X-ray interpretation [9-11]. Lung ultrasound, on the other hand, is an excellent tool to evaluate lung edema compared to auscultation and X-ray [12,13].
Assessment of Pulmonary Edema: Principles and Practice
2018, Journal of Cardiothoracic and Vascular Anesthesia
Presented in part at the annual meeting of the American Society of Anesthesiologists, Atlanta, Oct 12, 1983.
Manuscript received December 27; revision accepted May 7.
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Fellow, Critical Care Medicine
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Assodate Professor of Anesthesia (Clinical)
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Assistant Professor of Anesthesia
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Resident, Diagnostic Radiology.
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Assistant Professor of Radiology.
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Professor of Radiology.