The effect of net fluid balance on extravascular lung water assessed by lung ultrasound and electrical cardiometry / Mohamed Elsayed Abdelfatah Mohamed ; Supervised Ahmed Mohamed Mukhtar , Akram Shahat Eladawy , Mai Ahmed Ali

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

Background: It is well known that daily fluid balance is a predictor of outcome in critically ill patients. A positive fluid balance contributes to increased mortality both in medical and surgical patients. However, the reliability of fluid balance calculations is questioned. Lung ultrasound has been introduced to assess EVLW through detection of B line artifacts. Electrical cardiometry is a type of impedance cardiography, non-invasive and continuously applicable method to assess hemodynamic variables. Thoracic fluid content (TFC) is one of these variables that reflect both thoracic intravascular and extravascular fluids.Objectives: Our study aimed to correlate the three days cumulative fluid balance with extravascular lung water assessed by LUS and electrical cardiometry by the end of the third day, and to assess the diagnostic accuracy of electrical cardiometry in assessment of TFC in comparison to lung ultrasound.Methodology: In a prospective cohort study, 30 patients were assessed twice in the first and third day of inclusion for lung ultrasound score by lung ultrasound and TFC by electrical cardiometry to be correlated with 3 days cumulative balance.Results: There was no correlation between cumulative balance and both lung ultrasound score, TFC, and Ee' ratio (p = 0.57, 0.18, 0.99 respectively). There was significant correlation between TFC and LUS at day 1 and day 3(r= 0.610, p < 0.01), (r=0.4, p=0.05) respectively. There was no relationship between Ee' and both TFC and LUS at day 1, however, it became significant at day 3. The TFC correlated significantly with LUS in patients with negative fluid balance but not in those with positive fluid balance. By the same token, LUS was correlated significantly with Ee' in patients with negative balance only. However, no correlation was found between TFC and Ee' in patients with either negative or positive fluid balance

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