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Extravascular lung water index and global end-diastolic volume index should be corrected in children

Joris Lemson1, Peter Merkus, Johannes G van der Hoeven

  • 1Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, The Netherlands. j.lemson@ic.umcn.nl

Journal of Critical Care
|March 29, 2011
PubMed

Insights

Extravascular lung water index (EVLWI) is higher and global end-diastolic blood volume index (GEDVI) is lower in children due to developing organ-to-body weight ratios. These findings explain physiological variations in fluid status measurements during growth.

Area of Science:

  • Pediatric critical care medicine
  • Physiology
  • Hemodynamic monitoring

Background:

  • Accurate hemodynamic monitoring is crucial in pediatric critical care.
  • The extravascular lung water index (EVLWI) and global end-diastolic blood volume index (GEDVI) are key parameters.
  • Pediatric reference values for EVLWI and GEDVI differ from adults, necessitating explanation.

Purpose of the Study:

  • To elucidate the reasons behind higher EVLWI and lower GEDVI in young children.
  • To investigate the influence of growth and development on these hemodynamic indices.

Main Methods:

  • Literature data from autopsy and CT studies on pediatric organ weights and lung measurements were pooled.
  • Age, height, body weight, and body surface area (BSA) data were collected.
  • Lung weight-to-body weight and heart weight-to-BSA ratios were calculated and compared to growth patterns.

Main Results:

  • Lung weight relative to body weight increases slower than body weight itself, leading to higher pulmonary blood volume and EVLWI in younger children.
  • End-diastolic blood volume and heart weight increase faster than BSA, explaining the lower GEDVI in young children.
  • Proposed correction factors for comparing pediatric EVLWI and GEDVI with adult values.

Conclusions:

  • The observed differences in EVLWI and GEDVI in young children are attributed to dynamic changes in organ-to-body weight relationships during growth.
  • Understanding these physiological variations is essential for accurate interpretation of hemodynamic data in pediatric patients.
Abstract

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