{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:18:46Z","timestamp":1787847526054,"version":"build-2784847793"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Rising extravascular lung-water index (ELWI) following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC), if not timely intervened, can progress to pulmonary oedema. Transpulmonary thermodilution (TPTDL) is a standard technique to estimate ELWI (T-ELWI score), and track ongoing changes. Lung ultrasound (LUS) is another technique for ELWI (L-ELWI score) estimation. However, reproducibility and reliability of LUS for tracking serial L-ELWI changes during CRS + HIPEC remains to be validated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This prospective observational study included 360 L-ELWI and T-ELWI measurements at 12 peri-operative time-points. Cohen's Kappa test was used to assess reproducibility, Inter-rater agreement (between the anaesthetist and radiologist), and agreement between LUS and TPTDL for classifying the severity of pulmonary oedema. Reliability of LUS for 'tracking serial changes' in ELWI over time in individual patients was assessed by determining the repeated measures correlation (z-rrm) between weighted L-ELWI and T-ELWI scores. The ability of both techniques to discriminate pulmonary oedema was compared by analysing the area under ROC curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Excellent inter-rater agreement for assigned L-ELWI scores was observed (linear weighted \u03ba = 0.95 for both). Both techniques had a good agreement in classifying the severity of pulmonary oedema (linear weighted \u03ba = 0.63, 95% CI 0.51\u20130.79). T-ELWI and weighted L-ELWI scores correlated strongly (z-rrm = 0.88, 95% CI 0.80\u20130.92,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). Both techniques had comparable ability to discriminate pulmonary oedema (difference in area under ROC curve = 0.0014, 95%CI \u20130.0027 to 0.0055,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.5043).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We found the utility of LUS as a reliable and reproducible technique for ELWI estimation and tracking its changes over time in CRS + HIPEC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_1513_20","type":"journal-article","created":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T05:30:31Z","timestamp":1624426231000},"page":"458-464","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Utility of lung ultrasound for extravascular lung water volume estimation during cytoreductive surgery and hyperthermic intraperitoneal chemotherapy"],"prefix":"10.4103","volume":"65","author":[{"given":"Amit Kumar","family":"Mittal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiten","family":"Jaipuria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Bhatnagar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Chawla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivendra","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-6-20240902","doi-asserted-by":"crossref","first-page":"972","DOI":"10.4103\/ija.IJA_765_19","article-title":"Society of Onco-Anaesthesia and perioperative care consensus guidelines for perioperative management of patients for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)","volume":"63","author":"Solanki","year":"2019","journal-title":"Indian J Anaesth"},{"key":"R2-6-20240902","doi-asserted-by":"crossref","first-page":"162","DOI":"10.4103\/ija.IJA_170_18","article-title":"Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Fluid and temperature remain the culprit!","volume":"62","author":"Garg","year":"2018","journal-title":"Indian J Anaesth"},{"key":"R3-6-20240902","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1097\/CCM.0b013e31828a4643","article-title":"Quantitative diagnosis of diffuse alveolar damage using extravascular lung water","volume":"41","author":"Tagami","year":"2013","journal-title":"Crit Care Med"},{"key":"R4-6-20240902","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1097\/CCM.0b013e31826ab377","article-title":"Extravascular lung water is an independent prognostic factor in patients with acute respiratory distress syndrome","volume":"41","author":"Cordemans","year":"2013","journal-title":"Crit Care Med"},{"key":"R5-6-20240902","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1097\/CCM.0b013e31826ab377","article-title":"Extravascular lung water is an independent prognostic factor in patients with acute respiratory distress syndrome","volume":"41","author":"Jozwiak","year":"2013","journal-title":"Crit Care Med"},{"key":"R6-6-20240902","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s13089-017-0068-x","article-title":"A simplified lung ultrasound approach to detect increased extravascular lung water in critically ill patients","volume":"9","author":"Anile","year":"2017","journal-title":"Crit Ultrasound J"},{"key":"R7-6-20240902","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1378\/chest.127.5.1690","article-title":"\u201cUltrasound comet-tail images\u201d: A marker of pulmonary edema: A comparative study with wedge pressure and extravascular lung water","volume":"127","author":"Agricola","year":"2005","journal-title":"Chest"},{"key":"R8-6-20240902","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s13054-015-0756-5","article-title":"Simplified lung ultrasound protocol shows excellent prediction of extravascular lung water in ventilated intensive care patients","volume":"19","author":"Enghard","year":"2015","journal-title":"Crit Care"},{"key":"R9-6-20240902","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1093\/eurheartj\/ehw164","article-title":"Ultrasound of extravascular lung water: A new standard for pulmonary congestion","volume":"37","author":"Picano","year":"2016","journal-title":"Eur Heart J"},{"key":"R10-6-20240902","doi-asserted-by":"crossref","first-page":"456","DOI":"10.3389\/fpsyg.2017.00456","article-title":"Repeated measures correlation","volume":"8","author":"Bakdash","year":"2017","journal-title":"Front Psychol"},{"key":"R11-6-20240902","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s13613-015-0081-9","article-title":"Extravascular lung water in critical care: Recent advances and clinical applications","volume":"5","author":"Jozwiak","year":"2015","journal-title":"Ann Intensive Care"},{"key":"R12-6-20240902","doi-asserted-by":"crossref","first-page":"2080","DOI":"10.1378\/chest.122.6.2080","article-title":"Prognostic value of extravascular lung water in critically ill patients","volume":"122","author":"Sakka","year":"2002","journal-title":"Chest"},{"key":"R13-6-20240902","doi-asserted-by":"crossref","first-page":"188","DOI":"10.4103\/ija.IJA_39_18","article-title":"Anaesthetic management and perioperative outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: A retrospective analysis","volume":"62","author":"Balakrishnan","year":"2018","journal-title":"Indian J Anaesth"},{"key":"R14-6-20240902","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/01.CCM.0000295314.01232.BE","article-title":"Extravascular lung water in sepsis-associated acute respiratory distress syndrome: Indexing with predicted body weight improves correlation with severity of illness and survival","volume":"36","author":"Phillips","year":"2008","journal-title":"Crit Care Med"},{"key":"R15-6-20240902","doi-asserted-by":"crossref","first-page":"244","DOI":"10.21037\/jgo.2018.12.09","article-title":"Inflammatory response and optimalisation of peri-operative fluid administration during hyperthermic intraoperative intraperitoneal chemotherapy surgery","volume":"10","author":"de Witte","year":"2019","journal-title":"J Gastrointest Oncol"},{"key":"R16-6-20240902","first-page":"360","article-title":"Cardiovascular and pulmonary changes in patients with an isolated cerebral lesion. II. Extravascular lung water and pulmonary gas exchange (Neurogenic Pulmonary Edema)","volume":"38","author":"Singbartl","year":"1989","journal-title":"Anaesthesist"},{"key":"R17-6-20240902","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1056\/NEJMra032401","article-title":"Acute renal failure and sepsis","volume":"351","author":"Schrier","year":"2004","journal-title":"N Engl J Med"},{"key":"R18-6-20240902","first-page":"310","article-title":"Time course of cytokines, hemodynamic and metabolic parameters during hyperthermic intraperitoneal chemotherapy","volume":"82","author":"Coccolini","year":"2016","journal-title":"Minerva Anestesiol"},{"key":"R19-6-20240902","doi-asserted-by":"crossref","first-page":"5263717","DOI":"10.1155\/2019\/5263717","article-title":"Network of mediators for vascular inflammation and leakage is dysbalanced during cytoreductive surgery for late-stage ovarian cancer","volume":"2019","author":"Klaschik","year":"2019","journal-title":"Mediators Inflamm"},{"key":"R21-6-20240902","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.4103\/ija.IJA_480_20","article-title":"Perioperative factors predicting delayed enteral resumption and hospital length of stay in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: Retrospective cohort analysis from a single centre in India","volume":"64","author":"Balakrishnan","year":"2020","journal-title":"Indian J Anaesth"},{"key":"R22-6-20240902","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.3889\/oamjms.2019.173","article-title":"The impact of goal-directed fluid therapy in prolonged major abdominal surgery on extravascular lung water and oxygenation: A randomized controlled trial","volume":"7","author":"Hasanin","year":"2019","journal-title":"Open Access Maced J Med Sci"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.IJA_1513_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:20:33Z","timestamp":1787844033000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.IJA_1513_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_1513_20","relation":{},"ISSN":["0019-5049"],"issn-type":[{"value":"0019-5049","type":"print"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}