Anaesthesia/Wiley Project Grant

The successful applicants for the Anaesthesia/Wiley Research Grant were:

Principal Applicant

Dr Vasileios Zochios
Papworth Hospital, Cambridge

Extravascular lung water as an early predictor and marker of the severity of reperfusion lung injury in pulmonary endarterectomy: A prospective cohort study


Scientific Abstract

Reperfusion lung injury occurs in up to 40% of patients undergoing pulmonary endarterectomy and has been shown to represent a high permeability form of pulmonary oedema. It is associated with prolonged mechanical ventilation and intensive care unit stay and in its severe form it may result in death. Extravascular lung water measured by transpulmonary thermodilution is identified as early indicator of lung injury in critically ill patients with established acute respiratory distress syndrome. In this prospective cohort study we aim to evaluate extravascular lung water indexed to predicted body weight, using pulse-induced contour cardiac output monitor as a predictor of clinically significant peri-operative reperfusion injury in patients undergoing pulmonary endarterectomy. We hypothesise that pulmonary endarterectomy patients with high perioperative extravascular lung water indexed to predicted body weight values, are more likely to develop clinically significant reperfusion injury. A sample size of 51 patients is estimated to provide 80% (a=0.05) power to detect correlations and differences. As a unique in vivo example of high permeability oedema, pulmonary endarterectomy patients constitute an ideal model for evaluating whether extravascular lung water correlates with clinical outcomes and assessing its applicability as diagnostic criterion in the definition of acute respiratory distress syndrome.