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REVIEW

Measurement of extravascular lung water using the single indicator method in patients: research and potential clinical value

¹Department of Surgery, ; ²The Cardiovascular Research Institute, ; ³Division of Nephrology and Critical Care Medicine, Department of Medicine, and ; ⁴Departments of Medicine and Anesthesia, University of California-San Francisco, San Francisco, California

Extravascular lung water includes all of the fluid within the lung but outside of the vasculature. Lung water increases as a result of increased hydrostatic vascular pressure or from an increase in lung endothelial and epithelial permeability or both. Experimentally, extravascular lung water has been measured gravimetrically. Clinically, the chest radiograph is used to determine whether extravascular lung water is present but is an insensitive instrument for determining the quantity of lung water. Bedside measurement of extravascular lung water in patients is now possible using a single indicator thermodilution method. This review critically evaluates the experimental and clinical evidence supporting the potential value of measuring extravascular lung water in patients using the single indicator method.

acute lung injury; acute respiratory distress syndrome; pulmonary edema