Near-normal values of extravascular lung water in children

Area of Science:

• Pediatric Critical Care Medicine
• Respiratory Physiology
• Diagnostic Imaging

Background:

• Accurate assessment of extravascular lung water (EVLW) is crucial in pediatric critical care.
• Existing reference values for EVLW are limited, particularly in diverse pediatric populations.
• Establishing age-specific normal values is essential for precise interpretation of EVLW measurements.

Purpose of the Study:

• To define near-normal values of extravascular lung water indexed to body weight in children.
• To investigate the relationship between age and extravascular lung water indexed to body weight.
• To explore extravascular lung water indexed to height as a potential age-independent metric.

Main Methods:

• Prospective, multicenter observational study involving 58 children across 5 hospitals.
• Extravascular lung water was measured in pediatric intensive care unit (PICU) patients after illness resolution.
• Measurements were indexed to body weight and height and analyzed in relation to patient age.

Main Results:

• Extravascular lung water indexed to body weight showed a strong correlation with age (r² = 0.7).
• Age-specific reference ranges (5th-95th percentile) were established: <1 year (9-29 mL/kg), 1-5 years (7-25 mL/kg), and 5-17 years (5-13 mL/kg).
• Extravascular lung water indexed to height demonstrated an age-independent near-normal value (<315 mL/m).

Conclusions:

• Younger children exhibit higher extravascular lung water indexed to body weight values.
• Age-categorized near-normal values for extravascular lung water indexed to body weight are provided for clinical application.
• Indexing extravascular lung water to height is proposed as a potentially more age-independent measure.