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

Author(s)

Santos, Thiago M. ^[1] ; Franci, Daniel ^[1] ; Gontijo-Coutinho, Carolina M. ^[1] ; Ozahata, Tatiana Mirabetti ^[1] ; Guerra Grangeia, Tiago de Araujo ^[1] ; Matos-Souza, Jose R. ^[2] ; Carvalho-Filho, Marco A. ^[1]

Affiliation

^[1] Univ Estadual Campinas, Hosp Univ Campinas, Discipline Emergency Med, 126 Tessalia Vieira Camargo St, BR-13083887 Campinas, SP - Brazil

^[2] Univ Estadual Campinas, Hosp Univ Campinas, Discipline Cardiol, 126 Tessalia Vieira Camargo St, BR-13083887 Campinas, SP - Brazil

• Document type: Journal article
• Source: JOURNAL OF CRITICAL CARE; v. 44, p. 392-397, APR 2018.
• Web of Science Citations: 0

Abstract

Purpose: Lung 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 methods: In 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 5 min of fluid therapy. Results: Fifty patients were enrolled in 3 months. The LUS correlated with E/e' (r = .58, P < 0.0001). The LUS also increased among E/e' quartiles (Q) (Q1: E/e' <= 4.49; Q2: 4.49 < E/e' <= 5.49; Q3: 5.49 < E/e' <= 7.11; Q4: >7.11; 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). Conclusion: In 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. (C) 2017 Elsevier Inc. All rights reserved. (AU)

• FAPESP's process: 11/13785-0 - Impact of the early goal-directed therapy of severe sepsis and septic shock in the endoplasmic reticulum stress, myocardial function and mortality in patients treated at an emergency unit
• Grantee: Marco Antonio de Carvalho Filho
• Support Opportunities: Regular Research Grants