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Prediction of cardiogenic pulmonary edema onset by monitoring right lung impedance

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Abstract

Objective

To evaluate the ability of internal thoracic impedance (ITI) monitors to predict cardiogenic pulmonary edema in patients at risk.

Design and Setting

Prospective, controlled multicenter study.

Patients

We examined 328 consecutive patients admitted for cardiac conditions. Of these 265 patients aged 27–83 years with no clinical signs of pulmonary edema, extracardiac respiratory failure or pacemakers comprised the study cohort.

Intervention

Monitoring of the lung's electrical impedance was used for predicting cardiogenic pulmonary edema since accumulation of blood and fluid decreases impedance values.

Measurements and results

Impedance of the lung is the main feature of ITI measured by the RS-207 monitor: decreased ITI prior to the clinical signs of cardiogenic pulmonary edema was used as the prediction criterion. The clinical signs used for confirmation of its prediction were dyspnea, cyanosis, pulmonary rales, crepitations, arterial hypoxemia, and radiographic evidence of pulmonary congestion in chest radiographs. Clinicians were blinded to the results of ITI measurements and radiologists were blinded to both ITI and clinical data. Thirty-seven patients developed cardiogenic pulmonary edema while being monitored. ITI decreased by more than 12% of baseline in all of them; this occurred at 30 min or longer (26 patients) and at 60 min or longer (11 patients) before the appearance of clinical signs. ITI fell by less then 10.1% of baseline in all 228 patients who did not develop the edema.

Conclusion

Monitoring ITI is suitable for early prediction of cardiogenic pulmonary edema, before the appearance of the clinical signs.

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Acknowledgements

We are grateful to Dr. Alexander M. Samarov for help in statistical analysis. Esther Eshkol is thanked for manuscript preparation.

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Authors and Affiliations

  1. Heart Institute, Hillel Yaffe Medical Center, Rappoport Faculty of Medicine, Technion, Haifa, Israel

    Michael Shochat & Simcha Meisel

  2. Department of Internal Medicine C, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel

    Gideon Charach, Moshe Weintraub & Pavel Rabinovich

  3. Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel

    Shmuel Meyler

  4. Holon Academic Institute of Technology, Jerusalem, Holon, Israel

    Galina Mengeritsky

  5. Hadassah-Hebrew University Medical Center, Heart Institute, P.O. Box 12,000, 91120, Jerusalem, Israel

    Morris Mosseri

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  1. Michael Shochat
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  2. Gideon Charach
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  3. Shmuel Meyler
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  4. Simcha Meisel
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  5. Moshe Weintraub
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  6. Galina Mengeritsky
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  7. Morris Mosseri
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  8. Pavel Rabinovich
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Corresponding author

Correspondence to Morris Mosseri.

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Shochat, M., Charach, G., Meyler, S. et al. Prediction of cardiogenic pulmonary edema onset by monitoring right lung impedance. Intensive Care Med 32, 1214–1221 (2006). https://doi.org/10.1007/s00134-006-0237-z

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  • DOI: https://doi.org/10.1007/s00134-006-0237-z

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