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Acute Respiratory Distress Syndrome

Can we quantify pulmonary edema?

Would it not be great if you could quantify pulmonary edema in complex indications such as ARDS? The parameter Extra Vascular Lung Water (EVLW) reflects the interstitial, intracellular, alveolar, and lymphatic fluid in the lungs.

Thus, for diagnosis and management of ARDS, EVLW is a valuable tool and helps to base decisions on facts not on feelings.

Clinical issue: Chest x-rays do not reliably reflect the level of pulmonary oedema.

Severe pulmonary edema

Moderate pulmonary edema

No pulmonary edema

The quality of x-ray is influenced by many factors:

Accurate patient position

X-Ray intensity


"PiCCO provides...  relevant information on preload responsiveness indexes, cardiac output and extravascular lung water...  PiCCO thus allow clinicians to take rapidly appropriate decisions... to continue and  to stop fluid administration”.


Jean-Louis Teboul, MD, Professor
Service de Réanimation médicale, Centre Hospitalier Universitaire de Bicètre,
Paris, France

“In the PiCCO monitor I have one machine that can safely provide me with all the information needed ... I am able to measure the effects of my therapeutic interventions on extravascular lung water – all at a per patient cost only slightly greater than a standard arterial line.”


Charles Phillips, MD, Assistant Professor
Oregon Health and Science University, Portland, Oregon, USA