The bedside determination of extravascular lung water

Abstract

Using the formulae of Fazio and coworkers, we calculated the extravascular lung water per unit of blood volume (ELW/V) and per unit of blood flow (ELW/F) after intravenous injection of ^113mIntransferrin as the blood label, and ¹²³I-antipyrine as the diffusible, i.e. water label. Time-activity curves were recorded over the right anterior upper chest wall using a mobile detector. The curves were digitalized and fitted to a gamma-variate using a GAMMA-11 computer. Area over height calculations gave the mean transit times $\overline t$. Sixteen control subjects, without evidence of cardiac or pulmonary disease, and 10 patients, with clinical and radiological evidence of left heart failure, were examined. In the control group ELW/V was 0.37±0.17 and ELW/F 3.39±1.56 (mean±1 SD). In the patients ELW/V was 0.71±0.26 and ELW/F 13.10±5.67. The difference between both ELW/V and ELW/F for the control group and the patient group is statistically significant. Our values for ELW/V both in patients and control subjects are very similar to those obtained by Fazio and coworkers using H₂ ¹⁵O. However, our values for ELW/F differed from those of Fazio; this could be partly due to dependence of this parameter on the cardiac output.