Introduction Extravascular lungwater (EVLW) can be measured at the bedside using the transpulmonary thermodilution method (TPTD), which quantifies the amount of pulmonary edema. This technique has never been validated in conditions of high indexed EVLW levels measured in infants and young children. We compared EVLW_TPTD measurements with the transpulmonary double indicator dilution method (TPDD; ice-cold indocyanin green) and post mortem gravimetry.

Methods In eleven newborn lambs pulmonary edema was induced using a surfactant wash-out lavage ALI model. Serial EVLW measurements by TPTD and TPDD were performed at various levels of lung water and the final EVLW values were compared with the post mortem gravimetry results. Data were analyzed using correlation statistics (Spearman’s coefficient of rank correlation (rho)).

Results A total of 25 simultaneous TPTD and TPDD measurements from ten lambs were analyzed with a median EVLWI_TPDD of 24.0 (IQR 20.7) ml/kg. One lamb died before the measurements were performed. Correlation between EVLW_TPTD and EVLW_TPDD was r=0.94 (figure 1; p<0.0001, 95%CI 0.87–0.97). Median EVLW_Gravimetry was 23.9 (IQR9.4) ml/kg. The correlation between the final EVLW_TPTD and the EVLW_Gravimetry was r=0.93 (figure 2; p<0.0002, 95%CI 0.71–0.99).

Conclusions EVLW measurements by TPTD in severe pulmonary edema correlate well with the gold standards.

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Abstract 13 Figure 1

Correlation EVLW-TPTD and EVLW-TPDD

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Abstract 13 Figure 2

Correlation EVLW-TPTD and EVLW-gravimetry