[The clinical application of pulmonary vascular permeability index on differential diagnosis of acute pulmonary edema].

OBJECTIVE: To assess the value of pulmonary vascular permeability index in differentiating acute lung injury (ALI) from cardiac pulmonary edema.

METHODS: Critically ill patients with acute pulmonary edema were included from May, 2004 to September, 2008. Patients were divided into two groups, the ALI group and the cardiac pulmonary edema group (C group). Pulmonary vascular permeability index (PVPI), intrathoracic blood volume (ITBVI) were determined by pulse indicator continuous cardiac output (PiCCO) system.

RESULTS: (1) Thirty-four patients were enrolled, 22 cases in ALI group and 12 cases in C group. (2) The PVPI in patients of ALI group (2.7 ± 1.4) was higher than that of C group (1.9 ± 0.6; P < 0.05). EVLWI and ITBVI did not have the significant difference between the two groups (P > 0.05). (3) PVPI was positively correlated with EVLWI (r = 0.762), negatively correlated with PaO2/FiO2 (r = -0.478). (4) ARDS was diagnosed in 13 cases, including 8 pulmonary cause (ARDSp) and 5 extra-pulmonary cause (ARDSexp). PVPI, EVLW/ITBV and EVLWI of patients with ARDSexp were obviously higher than those with ARDSp.

CONCLUSIONS: PVPI may be useful for differentiating the types of pulmonary edema in the critically ill.