[Accuracy and clinical problems involved in the measurements of extravascular lung water, using the thermal-sodium...

In this report, we evaluated and discussed the accuracy and the clinical problems involved in measurements of extravascular lung water volume (EVLW), using the thermal-sodium double indicator dilution technique. We measured EVLW in 2 groups, group I (normal cardiac function group) consisting of 20 patients with esophageal cancer, and group II (low cardiac function group) consisting of 27 patients with heart valvular disease. No significant difference was found between the two groups in the reproducibility (SDM/Average X 100) of measurements of Cardiac output (CO), MTT (Mean Transient Time), and EVLW. No correlation was found between circulatory parameters and the reproducibility of measurement of EVLW. So we assumed that cardiac function has no influence on the reproducibility of EVLW measurement. But the CO measured with EVLW catheter was significantly higher than that measured with Swan-Ganz catheter in group II. We thought that EVLW should be calculated using the CO measured with Swan-Ganz catheter in cases of low cardiac function. Infection, thromboembolism and bleeding after the insertion of the catheter, overload of water and sodium due to the injection of the indicator were thought to be complications of measurement of EVLW. But in our clinical cases there was no such complication.