| Determining the aetiology of pulmonary oedema by the oedema fluid-to-plasma protein ratio. | |
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MedLine Citation:
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PMID: 19741024 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We hypothesised that the oedema fluid-to-plasma protein (EF/PL) ratio, a noninvasive measure of alveolar capillary membrane permeability, can accurately determine the aetiology of acute pulmonary oedema. 390 mechanically ventilated patients with acute pulmonary oedema were enrolled. A clinical diagnosis of acute lung injury (ALI), cardiogenic pulmonary oedema or a mixed aetiology was based on expert medical record review at the end of hospitalisation. The EF/PL ratio was measured from pulmonary oedema fluid and plasma samples collected at intubation. 209 patients had a clinical diagnosis of ALI, 147 had a diagnosis of cardiogenic pulmonary oedema and 34 had a mixed aetiology. The EF/PL ratio had an area under the receiver-operating curve of 0.84 for differentiating ALI from cardiogenic pulmonary oedema. Using a predefined cut-off of 0.65, the EF/PL ratio had a sensitivity of 81% and a specificity of 81% for the diagnosis of ALI. An EF/PL ratio >/=0.65 was also associated with significantly higher mortality and fewer ventilator-free days. Noninvasive measurement of the EF/PL ratio is a safe and reliable bedside method for rapidly determining the aetiology of acute pulmonary oedema that can be used at the bedside in both developed and developing countries. |
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Authors:
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L B Ware; R D Fremont; J A Bastarache; C S Calfee; M A Matthay |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2009-09-09 |
Journal Detail:
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Title: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology Volume: 35 ISSN: 1399-3003 ISO Abbreviation: Eur. Respir. J. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-02-03 Completed Date: 2010-11-16 Revised Date: 2013-03-20 |
Medline Journal Info:
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Nlm Unique ID: 8803460 Medline TA: Eur Respir J Country: Switzerland |
Other Details:
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Languages: eng Pagination: 331-7 Citation Subset: IM |
Affiliation:
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Division of Allergy, Pulmonary and Critical Care Medicine, Dept of Medicine, Vanderbilt University School of Medicine, T1218 MCN, 1161 21st Avenue S, Nashville, TN 37232-2650, USA. lorraine.ware@vanderbilt.edu |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Proteins / analysis* Cohort Studies Female Humans Male Middle Aged Oxygen / metabolism Permeability Pulmonary Alveoli / metabolism Pulmonary Edema / blood, diagnosis*, etiology* ROC Curve Respiratory Distress Syndrome, Adult / blood, diagnosis*, etiology* |
| Grant Support | |
ID/Acronym/Agency:
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HL 081332/HL/NHLBI NIH HHS; HL 51856/HL/NHLBI NIH HHS; HL090833/HL/NHLBI NIH HHS; K23 HL090833/HL/NHLBI NIH HHS; K24 HL103836/HL/NHLBI NIH HHS; R37 HL051856-14/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Blood Proteins; 7782-44-7/Oxygen |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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