Extravascular lung water correlates multiorgan dysfunction syndrome and mortality in sepsis

Fu-Tsai Chung, Horng-Chyuan Lin, Chih-Hsi Kuo, Chih-Teng Yu, Chun-Liang Chou, Kang-Yun Lee, Han-Pin Kuo, Shu-Min Lin, Fu-Tsai Chung, Horng-Chyuan Lin, Chih-Hsi Kuo, Chih-Teng Yu, Chun-Liang Chou, Kang-Yun Lee, Han-Pin Kuo, Shu-Min Lin

Abstract

Background: This study was designated to investigate whether increased extravascular lung water index (EVLWI) may correlate multiple organ dysfunction syndrome (MODS) and mortality in sepsis.

Methods: We designed a prospective cohort study in an intensive care unit of a tertiary care hospital. Sixty-seven patients with severe sepsis were included. Data were used to determine an association between EVLWI and the development of MODS and mortality. These connections were determined by the multiple logistic regression, plotting the receiver operating characteristic (ROC) curve and by Spearman test.

Results: EVLWI levels were higher in MODS patients on day 1 (median (IQR), 18(12.8-23.9) ml/kg, n = 38, p<0.0001) than in those without (median (IQR), 12.4 (7.9-16.3) ml/kg, n = 29) and day 3 (median (IQR), 17.8 (11.2-22.8) ml/kg, n = 29, p = 0.004) than in those without (median (IQR), 12.4 (8.0-16.3) ml/kg, n = 29). EVLWI was used as an independent predictor of the development of MODS (odds ratio, 1.6; p = 0.005; 95% confidence interval, 1.2∼2.2) during ICU stay. The area under the ROC curve showed that EVLWI levels could predict MODS (0.866) and mortality (0.881) during ICU stay. Meanwhile, the higher of SOFA score, the more EVLWI was found on day 1 (r = 0.7041, p<0.0001) and day 3 (r = 0.7732, p<0.0001).

Conclusions: Increased EVLWI levels correlates development of MODS and mortality during the patients' ICU stay. Further more, the potential of novel treatment in severe sepsis with lung injury may develop.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Extravascular lung water index (EVLWI).
Figure 1. Extravascular lung water index (EVLWI).
EVLWI in patients with and without multi-organ dysfunction syndrome (MODS), and mortality in pulmonary sepsis (A) and in non-pulmonary sepsis patients (B), Open bars, patients with MODS or mortality; filled bars, patients without MODS or mortality. p value was expressed.
Figure 2. The relationship between extravascular lung…
Figure 2. The relationship between extravascular lung water index levels (EVLWI) and SOFA score in patients with severe sepsis.
The higher of SOFA score, the more EVLWI was found on day 1 (r = 0.7041, p

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Source: PubMed

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