The influence of extracorporeal circulation on extravascular lung water in coronary surgery patients.

The influence of extracorporeal circulation (ECC) on extravascular lung water (EVLW) was investigated in a total of 45 consenting patients undergoing coronary artery bypass surgery. The patients were subdivided into 3 groups according to positive fluid balance during ECC: 1. less than 500 ml; 2. 500 to 1500 ml; 3. 1500 to 3000 ml. Lung water measurement was performed intraoperatively using the thermal green-dye double indicator dilution technique, with indocyanine green and a microprocessed lung water computer, before and after ECC. In the group with high positive fluid balance during ECC (group 3) EVLW - increase was more pronounced (5.18 ml/kg----8.18 ml/kg) than in the groups with lower positive fluid input (group 1: 5.35 ml/kg----5.68 ml/kg, group 2: 5.56 ml/kg----6.70 ml/kg). Extravascular lung water increase was accompanied by a deterioration of pulmonary gas exchange demonstrated by the greatest decrease of paO2 in group 3 (490 mmHg----243 mmHg). No significant relationship of lung water changes to various hemodynamic parameters was observed in this study.