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This Article Full Text Full Text (PDF) Supplemental Figure All Versions of this Article: 294/6/L1023    most recent 00533.2007v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Effros, R. M. Articles by Casaburi, R. PubMed PubMed Citation Articles by Effros, R. M. Articles by Casaburi, R.

INVITED REVIEW

Indicator dilution measurements of extravascular lung water: basic assumptions and observations

Los Angeles Biomedical Institute at Harbor-UCLA Medical Center, Torrance, California

Since they were introduced more than five decades ago, a variety of single-pass indicator, thermal, and osmotic dilution approaches have been developed for detecting and measuring excess fluid in the lungs. This brief review discusses why studies of the extravascular lung water (EVLW) continue to intrigue physiologists and clinicians and the likelihood that they will become sufficiently reliable for more widespread use. Emphasis is placed on the basic assumptions that underlie these measurements and limitations imposed by the nature of the data that are collected. A distinction is made between approaches that are based on compartmental models of solute and water exchange and those that represent extensions of more conventional washout procedures, which have been utilized extensively for measurements of gas volumes in the lungs. Although the compartmental approach has been used to simplify indicator dilution studies by eliminating the need for a vascular indicator, it is based on assumptions that may not be realistic. Early recirculation inevitably limits the period in which observations can be made and impairs detection of those portions of the lungs with decreased perfusion. These general principles are also used to develop a new method of analyzing osmotic transient studies. A short account is given of EVLW observations that have been made in animals and humans. Both the sensitivity and specificity of EVLW measurements in humans are uncertain, and the normal clinical range of EVLW remains in doubt.

acute lung injury; adult respiratory distress syndrome; pulmonary edema; dye dilution techniques

This article has been cited by other articles:

				M. A. Matthay Measurement of extravascular lung water in patients with pulmonary edema Am J Physiol Lung Cell Mol Physiol, June 1, 2008; 294(6): L1021 - L1022. [Full Text] [PDF]