Year: 2009
Type: article
Study design: Observational Study
Abstract: We hypothesised that the oedema fluid-to-plasma protein (EF/PL) ratio, a noninvasive measure of alveolar capillary membrane permeability, can accurately determine the aetiology of acute pulmonary oedema. 390 mechanically ventilated patients with acute pulmonary oedema were enrolled. A clinical diagnosis of acute lung injury (ALI), cardiogenic pulmonary oedema or a mixed aetiology was based on expert medical record review at the end of hospitalisation. The EF/PL ratio was measured from pulmonary oedema fluid and plasma samples collected at intubation. 209 patients had a clinical diagnosis of ALI, 147 had a diagnosis of cardiogenic pulmonary oedema and 34 had a mixed aetiology. The EF/PL ratio had an area under the receiver-operating curve of 0.84 for differentiating ALI from cardiogenic pulmonary oedema. Using a predefined cut-off of 0.65, the EF/PL ratio had a sensitivity of 81% and a specificity of 81% for the diagnosis of ALI. An EF/PL ratio >/=0.65 was also associated with significantly higher mortality and fewer ventilator-free days. Noninvasive measurement of the EF/PL ratio is a safe and reliable bedside method for rapidly determining the aetiology of acute pulmonary oedema that can be used at the bedside in both developed and developing countries.
Source: European Respiratory Journal
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: G1894668648, Midcareer Investigator Award in Patient-Oriented Research in Acute Lung Injury, G3429402575, G3723776939, RESOLUTION OF CLINICAL LUNG INJURY, Impact of Cigarette Smoke Exposure on Acute Lung Injury, Biomarker Profiles in the Diagnosis/Prognosis of ARDS, Resolution of Clinical Lung Injury
OpenAlex ID: W2131858017