Authors: KUZKOV, V. V.; SUBOROV, E. V.; KIROV, M. Y.; WÆRHAUG, K.¹; MORTENSEN, R.²; KUKLIN, V. N.¹; NORDHUS, K. C.²; BJERTNÆS, L. J.¹

Source: Acta Anaesthesiologica Scandinavica, Volume 54, Number 8, September 2010 , pp. 1018-1026(9)

Publisher: Wiley-Blackwell

Abstract:

Background:

We hypothesized that in acute lung injury (ALI), the volume of pulmonary tissue with aqueous density, as determined by spiral computed tomography (CT), is associated with extravascular lung water content. Our aim was to compare tissue volume index, as assessed by CT, before and after oleic acid-induced ALI, with extravascular lung water indexes (EVLWI), determined with single transpulmonary thermodilution (EVLWI_STD), thermal-dye dilution (EVLWI_TDD), and postmortem gravimetry (EVLWI_G). Methods:

Seven instrumented sheep received an intravenous infusion of oleic acid 0.08 ml/kg (OA group) and four animals had vehicle only (Control group). The day before, and immediately after the experiment, sheep were anesthetized to undergo quantitative CT examinations during a short breath hold. Hemodynamics, oxygenation, EVLWI_STD, and EVLW_TDD were registered. Linear regression analysis was used to assess the relationships between EVLWI_STD, EVLW_TDD, EVLWI_G, and lung tissue volume index (TVI_CT) determined with CT. Results:

In the OA group, total lung volume increased compared with Controls. Poorly and non-aerated lung volumes increased a 3.6- and 4.9-fold, respectively, and TVI_CT almost doubled. EVLWI_STD, EVLWI_TDD, and TVI_CT were associated significantly with EVLWI_G (r=0.85, 0.90, and 0.88, respectively; P<0.001). TVI_CT deviated from the reference EVLWI_G values to the greatest extent with a mean bias ± 2SD of 4.0 ± 6.0 ml/kg. Conclusions:

In ovine oleic acid-induced ALI, lung tissue volume, as assessed by quantitative CT, is in close agreement with EVLWI, as determined by indicator dilution methods and postmortem gravimetry, but overestimates lung fluid content.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1399-6576.2010.02272.x

Affiliations: 1: Departments of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø and University Hospital of North Norway, Tromsø, Norway 2: Department of Radiology, University Hospital of North Norway, Tromsø, Norway.

Publication date: 2010-09-01

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