Plasma Volume Estimate Identified as Predictor for Deadly Lung Injury in Sepsis

A readily obtainable blood measurement may help clinicians identify sepsis patients at highest risk for a catastrophic lung complication.

Researchers analyzing data from 3,854 adults across multiple Chinese centers found that elevated estimated plasma volume status (ePVS) independently predicted the development of sepsis-associated acute respiratory distress syndrome (SA-ARDS). The marker is derived from routine clinical measurements.

Predictive performance was robust, with an area under the curve of 0.772 for identifying subsequent ARDS cases. The risk remained significant after rigorous statistical adjustment.

Patients who developed ARDS faced substantially grimmer outcomes. Mortality hit 31.8% among those with lung injury versus 23.1% in patients without it. They also required mechanical ventilation and continuous renal replacement therapy far more often.

ePVS levels increased alongside ARDS severity, proving particularly effective at distinguishing mild from moderate forms of the disease. Patients with pulmonary infections as the sepsis source also showed significantly higher values.

While ePVS alone had limited power to predict in-hospital death for existing SA-ARDS patients, pairing it with the APACHE II severity score markedly improved prognostic accuracy. Authors suggest incorporating ePVS into routine risk assessment could enable closer monitoring and personalized care.