Although there are a variety of techniques by which lung water can be measured in the critically ill, the important question remains as to whether such measurements lead to improvements in treatment and survival of critically ill patients. Several investigators have tried to establish the role of extravascular lung water measurements in clinical practice. Clinical management based on protocols incorporating extravascular lung water measurement has been associated with reduced mortality in acute respiratory distress syndrome and sepsis patients. Similarly, if patients were managed according to a protocol that emphasized fluid restriction when extravascular lung water was greater than 7 ml/kg, time in the ICU and ventilator days were significantly shorter than for a comparable group of patients whose fluid management was guided by wedge pressure measurements.
More clinical trials are needed if the value of extravascular lung water measurement is to be fully exploited. Chapter References
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