Fluid management in critically ill patients: the role of extravascular lung water, abdominal hypertension, capillary leak, and fluid balance

Cordemans et al. Annals of Intensive Care 2012, 2(Suppl 1):S1 http://www.annalsofintensivecare.com/content/2/S1/S1 RESEARCH Open Access Fluid manag...

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Cordemans et al. Annals of Intensive Care 2012, 2(Suppl 1):S1 http://www.annalsofintensivecare.com/content/2/S1/S1

RESEARCH

Open Access

Fluid management in critically ill patients: the role of extravascular lung water, abdominal hypertension, capillary leak, and fluid balance Colin Cordemans1, Inneke De laet1, Niels Van Regenmortel1, Karen Schoonheydt1, Hilde Dits1, Wolfgang Huber2, Manu LNG Malbrain1*

Abstract Introduction: Capillary leak in critically ill patients leads to interstitial edema. Fluid overload is independently associated with poor prognosis. Bedside measurement of intra-abdominal pressure (IAP), extravascular lung water index (EVLWI), fluid balance, and capillary leak index (CLI) may provide a valuable prognostic tool in mechanically ventilated patients. Methods: We performed an observational study of 123 mechanically ventilated patients with extended hemodynamic monitoring, analyzing process-of-care variables for the first week of ICU admission. The primary outcome parameter was 28-day mortality. ΔmaxEVLWI indicated the maximum difference between EVLWI measurements during ICU stay. Patients with a ΔmaxEVLWI