Association between different indexations of extravascular lung water (EVLW) and PaO2/FiO2: a two-center study in 231 patients.

<h4>Background</h4>Variability of body weight (BW) and height calls for indexation of volumetric hemodynamic parameters. Extravascular lung water (EVLW) has formerly been indexed to actual BW (BW(act)) termed EVLW-index (EVLWI). In overweight patients indexation to BW(act) might inapprop...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Wolfgang Huber, Josef Höllthaler, Tibor Schuster, Andreas Umgelter, Michael Franzen, Bernd Saugel, Colin Cordemans, Roland M Schmid, Manu L N G Malbrain
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/71749e27b78b41418ee2b5f3b6d03eb7
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:71749e27b78b41418ee2b5f3b6d03eb7
record_format	dspace
spelling	oai:doaj.org-article:71749e27b78b41418ee2b5f3b6d03eb72021-11-25T06:05:55ZAssociation between different indexations of extravascular lung water (EVLW) and PaO2/FiO2: a two-center study in 231 patients.1932-620310.1371/journal.pone.0103854https://doaj.org/article/71749e27b78b41418ee2b5f3b6d03eb72014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25093821/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Variability of body weight (BW) and height calls for indexation of volumetric hemodynamic parameters. Extravascular lung water (EVLW) has formerly been indexed to actual BW (BW(act)) termed EVLW-index (EVLWI). In overweight patients indexation to BW(act) might inappropriately lower indexed EVLWI(act). Several studies suggest indexation of EVLWI to predicted BW (EVLWI(pred)). However, data regarding association of EVLWI(act) and EVLW(pred) to mortality and PaO2/FiO2 are inconsistent. Two recent studies based on biometric database-analyses suggest indexation of EVLWI to height (EVLWI(height)). Therefore, our study compared the association of un-indexed EVLW, EVLWI(height), EVLW(pred) and EVLWI(act) to PaO2/FiO2 and Oxygenation index (OI = mean airway pressureFiO2/PaO2).<h4>Methods</h4>A total of 2119 triplicate transpulmonary thermodilutions (TPTDs; PiCCO; Pulsion Medical-Systems, Germany) were performed in 50 patients from the evaluation, and 181 patients from the validation groups. Correlations of EVLW and EVLWI to PaO2/FiO2, OI and ROC-AUC-analyses regarding PaO2/FiO2<200 mmHg (primary endpoint) and OI>10 were performed.<h4>Results</h4>In the evaluation group, un-indexed EVLW (AUC 0.758; 95%-CI: 0.637-0.880) and EVLWI(height) (AUC 0.746; 95%-CI: 0.622-0.869) provided the largest ROC-AUCs regarding PaO2/FiO2<200 mmHg. The AUC for EVLWI(pred) was smaller (0.713). EVLWI(act) provided the smallest AUC (0.685). This was confirmed in the validation group: EVLWI(height) provided the largest AUC (0.735), EVLWI(act) (0.710) the smallest. In the merged data-pool, AUC was significantly greater for EVLWI(height) (0.729; 95%-CI: 0.674-0.784) compared to all other indexations including EVLWI(act) (ROC-AUC 0.683, p = 0.007) and EVLWI(pred) (ROC-AUC 0.707, p = 0.015). The association of EVLW(I) was even stronger to OI compared to PaO2/FiO2. In the merged data-pool, EVLWI(height) provided the largest AUC regarding "OI>10" (0.778; 95%-CI: 0.713-0.842) compared to 0.739 (95%-CI: 0.669-0.810) for EVLWI(act) and 0.756 (95%-CI: 0.688-0.824) for EVLWI(pred).<h4>Conclusions</h4>Indexation of EVLW to height (EVLWI(height)) improves the association of EVLW(I) to PaO2/FiO2 and OI compared to all other indexations including EVLWI(pred) and EVLWI(act). Also considering two recent biometric database analyses, EVLWI should be indexed to height.Wolfgang HuberJosef HöllthalerTibor SchusterAndreas UmgelterMichael FranzenBernd SaugelColin CordemansRoland M SchmidManu L N G MalbrainPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 8, p e103854 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Wolfgang Huber Josef Höllthaler Tibor Schuster Andreas Umgelter Michael Franzen Bernd Saugel Colin Cordemans Roland M Schmid Manu L N G Malbrain Association between different indexations of extravascular lung water (EVLW) and PaO2/FiO2: a two-center study in 231 patients.
description	<h4>Background</h4>Variability of body weight (BW) and height calls for indexation of volumetric hemodynamic parameters. Extravascular lung water (EVLW) has formerly been indexed to actual BW (BW(act)) termed EVLW-index (EVLWI). In overweight patients indexation to BW(act) might inappropriately lower indexed EVLWI(act). Several studies suggest indexation of EVLWI to predicted BW (EVLWI(pred)). However, data regarding association of EVLWI(act) and EVLW(pred) to mortality and PaO2/FiO2 are inconsistent. Two recent studies based on biometric database-analyses suggest indexation of EVLWI to height (EVLWI(height)). Therefore, our study compared the association of un-indexed EVLW, EVLWI(height), EVLW(pred) and EVLWI(act) to PaO2/FiO2 and Oxygenation index (OI = mean airway pressureFiO2/PaO2).<h4>Methods</h4>A total of 2119 triplicate transpulmonary thermodilutions (TPTDs; PiCCO; Pulsion Medical-Systems, Germany) were performed in 50 patients from the evaluation, and 181 patients from the validation groups. Correlations of EVLW and EVLWI to PaO2/FiO2, OI and ROC-AUC-analyses regarding PaO2/FiO2<200 mmHg (primary endpoint) and OI>10 were performed.<h4>Results</h4>In the evaluation group, un-indexed EVLW (AUC 0.758; 95%-CI: 0.637-0.880) and EVLWI(height) (AUC 0.746; 95%-CI: 0.622-0.869) provided the largest ROC-AUCs regarding PaO2/FiO2<200 mmHg. The AUC for EVLWI(pred) was smaller (0.713). EVLWI(act) provided the smallest AUC (0.685). This was confirmed in the validation group: EVLWI(height) provided the largest AUC (0.735), EVLWI(act) (0.710) the smallest. In the merged data-pool, AUC was significantly greater for EVLWI(height) (0.729; 95%-CI: 0.674-0.784) compared to all other indexations including EVLWI(act) (ROC-AUC 0.683, p = 0.007) and EVLWI(pred) (ROC-AUC 0.707, p = 0.015). The association of EVLW(I) was even stronger to OI compared to PaO2/FiO2. In the merged data-pool, EVLWI(height) provided the largest AUC regarding "OI>10" (0.778; 95%-CI: 0.713-0.842) compared to 0.739 (95%-CI: 0.669-0.810) for EVLWI(act) and 0.756 (95%-CI: 0.688-0.824) for EVLWI(pred).<h4>Conclusions</h4>Indexation of EVLW to height (EVLWI(height)) improves the association of EVLW(I) to PaO2/FiO2 and OI compared to all other indexations including EVLWI(pred) and EVLWI(act). Also considering two recent biometric database analyses, EVLWI should be indexed to height.
format	article
author	Wolfgang Huber Josef Höllthaler Tibor Schuster Andreas Umgelter Michael Franzen Bernd Saugel Colin Cordemans Roland M Schmid Manu L N G Malbrain
author_facet	Wolfgang Huber Josef Höllthaler Tibor Schuster Andreas Umgelter Michael Franzen Bernd Saugel Colin Cordemans Roland M Schmid Manu L N G Malbrain
author_sort	Wolfgang Huber
title	Association between different indexations of extravascular lung water (EVLW) and PaO2/FiO2: a two-center study in 231 patients.
title_short	Association between different indexations of extravascular lung water (EVLW) and PaO2/FiO2: a two-center study in 231 patients.
title_full	Association between different indexations of extravascular lung water (EVLW) and PaO2/FiO2: a two-center study in 231 patients.
title_fullStr	Association between different indexations of extravascular lung water (EVLW) and PaO2/FiO2: a two-center study in 231 patients.
title_full_unstemmed	Association between different indexations of extravascular lung water (EVLW) and PaO2/FiO2: a two-center study in 231 patients.
title_sort	association between different indexations of extravascular lung water (evlw) and pao2/fio2: a two-center study in 231 patients.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/71749e27b78b41418ee2b5f3b6d03eb7
work_keys_str_mv	AT wolfganghuber associationbetweendifferentindexationsofextravascularlungwaterevlwandpao2fio2atwocenterstudyin231patients AT josefhollthaler associationbetweendifferentindexationsofextravascularlungwaterevlwandpao2fio2atwocenterstudyin231patients AT tiborschuster associationbetweendifferentindexationsofextravascularlungwaterevlwandpao2fio2atwocenterstudyin231patients AT andreasumgelter associationbetweendifferentindexationsofextravascularlungwaterevlwandpao2fio2atwocenterstudyin231patients AT michaelfranzen associationbetweendifferentindexationsofextravascularlungwaterevlwandpao2fio2atwocenterstudyin231patients AT berndsaugel associationbetweendifferentindexationsofextravascularlungwaterevlwandpao2fio2atwocenterstudyin231patients AT colincordemans associationbetweendifferentindexationsofextravascularlungwaterevlwandpao2fio2atwocenterstudyin231patients AT rolandmschmid associationbetweendifferentindexationsofextravascularlungwaterevlwandpao2fio2atwocenterstudyin231patients AT manulngmalbrain associationbetweendifferentindexationsofextravascularlungwaterevlwandpao2fio2atwocenterstudyin231patients
_version_	1718414169438420992

Association between different indexations of extravascular lung water (EVLW) and PaO2/FiO2: a two-center study in 231 patients.

Ejemplares similares