Pulmonary artery and noninvasive hemodynamics during lung lavage in primary alveolar proteinosis

Noninvasive hemodynamic monitoring by bioimpedance has been compared to cardiac output measured by thermodilution. The technology of bioimpedance does allow for monitoring of static thoracic impedance, a measurement thought to be affected by extravascular lung water. No contemporary studies (in the last 20 years) have examined the effectiveness of that parameter in measuring changes in lung water. This case report notes hemodynamics and examines thoracic impedance in a patient undergoing unilateral lung lavage. The hemodynamic data measured by bioimpedance and thermodilution correlated well (r = 0.97 for cardiac output). The changes in static impedance were compared to thoracic compliance during infusion of saline solution and evacuation. The changes in both parameters followed each other closely. Further work is required in patients with pulmonary edema or effusions before bioimpedance can be used to monitor such clinical events.