The change in hematocrit divided by the net fluid balance reflects how much fluid remained in or escaped from the vascular space. In severe sepsis there is increased vascular leak. The authors are from Harvard University.
If infused liquids remain in the vascular space, then the hematocrit should decline.
If infused liquids leak from the vascular space, then the hematocrit will be stable or increase.
Parameters:
(1) hematocrit initial, from 0 to 100
(2) hematocrit final, from 0 to 100
(3) new fluid balance (net volume of fluid administered), in mL
(4) body surface area (BSA), in square meters
vascular leak index =
= ((hematocrit final) - (hematocrit initial)) / (net fluid balance) * (BSA) * 1000
Interpretation:
• The lower the VLI the lower the in-hospital mortality.
• The higher the VLI the higher the in-hospital mortality, especially when >= 0.
• When the VLI is -4 the mortality rate is 13-14%.
• When the VLI is 1 the in-hospital mortality was 23-25%.
According to Supplement Figure 7
|
VLI
|
In-Hospital Mortality
|
|
-30
|
1.3%
|
|
-20
|
9.9%
|
|
-10
|
19.7%
|
|
0
|
29%
|
|
10
|
38.5%
|
