Journal of the Medical Association of Thailand Vol 94, No 2:FEBUARY 2011 (SUPPL.1) 0125-2208 94 2 2011 Feb Evaluation of Correlation between Vascular Pedicle Width and Intravascular Volume Status in Thai Critically Ill Patients 181 EN Sanit Wichansawakul Warakarn Vilaichone Surat Tongyoo Chairat Permpikul Suwimol Wonglaksanapimol Kantima Daengnim Girapong Suwanboonrit Original Article To evaluate the correlation between vascular pedicle widths (VPW) measured from portable chest roentgenogram(CXR) and intravascular volume status in Thai critically ill patients. A prospective cohort study included the critically ill patients in whom pulmonary artery catheter wasplaced in the Medical Intensive Care Units of Siriraj Hospital, Mahidol University between June 2009 and January 2010. Thepatient’s baseline characteristics, hemodynamic data measured from pulmonary artery catheter (PAC) and CXR parameterswere collected. From thirty-four patients, thirteen (38.2%) had high pulmonary artery occlusive pressure (PAOP >18 mmHg). Thepatients with high PAOP were older (69.8 + 8.8 years vs. 59.2 + 15.4 years, p = 0.02), taller (163.2 + 5.3 cm vs. 157.0 + 10.4cm, p = 0.03) and higher weight (67.4 + 12.9 kg vs. 57.1 + 7.8 kg, p = 0.007) than the low PAOP group. The correlationsbetween PAOP and VPW (r = 0.68, p < 0.001) as well as between PAOP and cardiothoracic ratio (CTR) (r = 0.23, p = 0.03)were significant. From the receiver operating characteristic (ROC) curve, VPW > 68 mm is the best parameter to predictPAOP > 18 mmHg (the area under the curve (AUC) = 0.853, p < 0.001, sensitivity = 92.3%, specificity = 85.7%). The CTR> 0.58 can be used to predict elevated PAOP > 18 mmHg with acceptable sensitivity = 85.74% and specificity = 76.9% (AUC= 0.727, p = 0.03). The peribronchial cuffing (PBC) was detected at a higher percentage among high PAOP group than in thelow PAOP group (76.9% vs. 33.3%, p = 0.03). The VPW > 68 mm, CTR > 0.58 and the present of PBC can be used together to predict elevation of PAOP > 18mmHg among the Thai critically ill patients. By using these CXR parameters, the PAC insertion may be avoided especially inpatients with contraindication. Intravascular volume Chest x-ray Vascular pedicle width critically ill patients Cardiothoracic ratio Pulmonaryatery ccclusive pressure