Journal of Clinical Monitoring

, Volume 6, Issue 2, pp 99–106 | Cite as

Commercial double-indicator-dilution densitometer using heavy water: Evaluation in oleic-acid pulmonary edema

  • Lars G. Leksell
  • Mark S. Schreiner
  • Angelina Sylvestro
  • Gordon R. Neufeld
Original Articles

Abstract

We evaluated a commercially available, double-indicator-dilution densitometric system for the estimation of pulmonary extravascular water volume in oleic acid-induced pulmonary edema. Indocyanine green and heavy water were used as the nondiffusible and diffusible tracers, respectively. Pulmonary extravascular water volume, measured with this system, was 67% of the gravimetric value (r = 0.91), which was consistent with values obtained from the radioisotope methods. The measured volume was not influenced by changes in cardiac index over a range of 1 to 4 L · min · m2. This system is less invasive than the thermal-dye technique and has potential for repeated clinical measurements of pulmonary extravascular lung water and cardiac output.

Key words

Lung: volume, extravascular water: edema Measurement techniques: densitometry 

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References

  1. 1.
    Chinard FP, Enns T, Nolan MF. Indicator-dilution studies with “diffusible” indicators. Circ Res 1962; 10:473–490PubMedGoogle Scholar
  2. 2.
    Zierler KL. Circulation times and the theory of indicatordilution methods for determining blood flow and volume. In: Handbook of physiology. Circulation, section 2, vol. 1. Washington, DC: American Physiological Society, 1962:585–615Google Scholar
  3. 3.
    Prys-Roberts C. Measurement of cardiac output and regional blood flow. In: Prys-Roberts C, ed. The circulation in anesthesia. Oxford: Blackwell, 1980:531–560Google Scholar
  4. 4.
    Chinard FP. Estimation of extravascular lung water by indicator dilution techniques. Circ Res 1975;37:137–142PubMedGoogle Scholar
  5. 5.
    Noble WH, Severinghaus JW. Thermal and conductivity dilution curves for rapid quantitation of pulmonary edema. J Appl Physiol 1972;32:770–774PubMedGoogle Scholar
  6. 6.
    Lewis FR, Elings VB, Hill SL, Christensen JM. The measurement of extravascular lung water by thermal-green dye indicator dilution. ANN NY Acad Sci 1982; 394–410Google Scholar
  7. 7.
    Sibbald WJ, Warshawski FJ, Short AK, et al. Clinical studies of measuring extravascular lung water by the thermal dye technique in critically ill patients. Chest 1983;83: 725–732PubMedCrossRefGoogle Scholar
  8. 8.
    Noble WH, Kay JC, Maret KH, Caskanette G. Reap-praisal of extravascular lung thermal volume as measure of pulmonary edema. J Appl Physiol 1980;48(1):120–128PubMedGoogle Scholar
  9. 9.
    Oppenhcimcr L, Elings VB, Lewis FR. Thermal-dye lung water measurements: effects of edema and embolization. J Surg Res 1979;26:504–513CrossRefGoogle Scholar
  10. 10.
    Basset G, Bouchonnet MF, Marsac J, et al. Simultaneous detection ot deuterium oxide and indocyanine green in flowing blood. J Appl Physiol 1981;50:1367–1371PubMedGoogle Scholar
  11. 11.
    Basset G, Moreau F. Simple method of measuring pulmonary extravascular water using heavy water. In: Klein ER, Klein PD, eds. Proceedings of the 2nd International Conference on Stable Isotopes, October 1975. Washington, DC: U.S. Government Printing Office, National Technical Information Service, 1976:310–324Google Scholar
  12. 12.
    DuBois D, DuBois EF. Clinical calorimetry. A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 1916; 17:863–871Google Scholar
  13. 13.
    Petersen BT, Brook JA, Zack AG. Use of a microwave oven for determination of postmortem water volume of lungs. J Appl Physiol 1982;52:1661–1663Google Scholar
  14. 14.
    Pearcc ML, Yamashita BA, Beazell B. Measurement of pulmonary edema. Circ Res 1965;16:482–488Google Scholar
  15. 15.
    Bland JM, Altman DG. Statistical methods for assessing agreement between two methods ot clinical measurement. Lancet 1986;1:307–310PubMedGoogle Scholar
  16. 16.
    Staub N, Hogg JC. Conference report of a workshop on the measurement of lung water. Crit Care Med 1980;8: 752–759PubMedCrossRefGoogle Scholar
  17. 17.
    Derks CM, Jacobovitz-Derks D. Embolie pneumopathy induced by oleic acid. Am J Pathol 1977:87:143–158PubMedGoogle Scholar
  18. 18.
    Fallon KD, Drake RE, Lame GA, Gabel JC. Effect of cardiac output on extravascular lung water estimates made with Edwards® lung water computer. Anesthesiology 1985;62:505–508PubMedCrossRefGoogle Scholar
  19. 19.
    Böck JC, Barker BC, Mackensie RC, et al. Cardiac output measurements using femoral artery thermodilution in patients. J Crit Care Mod 1989;4:106–111CrossRefGoogle Scholar
  20. 20.
    Schreiner MS. Leksell LG, Neufeld GR. Heavy water evaluated for dye-dilution cardiac output measurements. Clin Monit 1989;5:236CrossRefGoogle Scholar

Copyright information

© Little, Brown and Company 1990

Authors and Affiliations

  • Lars G. Leksell
    • 1
  • Mark S. Schreiner
    • 2
  • Angelina Sylvestro
    • 1
  • Gordon R. Neufeld
    • 1
  1. 1.Department ot AnesthesiaThe University of Pennsylvania School ot MedicinePhiladelphia
  2. 2.The Childrens Hospital ot PhiladelphiaPhiladelphia

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