Intensive Care Unit Department, "Saint Spiridon" University Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
Nephrology Department, Dialysis and Renal Transplant Center, "Dr. C.I. Parhon" University Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
Int Urol Nephrol. 2018 Jan;50(1):113-119. doi: 10.1007/s11255-017-1730-8. Epub 2017 Oct 30.
Fluid overload is frequently found in critically ill patients with acute kidney injury (AKI) and is associated with adverse outcomes. Lung ultrasonography (LUS) and bioimpedance spectroscopy (BIS) are potentially useful tools for the noninvasive volume assessment. We evaluated the utility of these measures, alone or in combination, in estimating the PaO/FiO ratio in critical patients with AKI.
In a prospective pilot observational study we included 45 patients who presented on admission or developed at any time during intensive care unit stay AKI defined according to KDIGO criteria. Patients were studied at baseline and after 48 h with LUS, BIS and arterial blood gas.
In the univariable analysis, the PaO/FiO ratio was negatively correlated with the B-lines score, and this association was maintained even after adjustments. A cutoff value of 17 for the B-lines score has a sensibility of 76% and a specificity of 65% in identifying patients with PaO/FiO < 300.
LUS can be used for functional lung evaluation and identification of patients with increase pulmonary water content and decrease PaO/FiO ratio.
急性肾损伤（AKI）危重症患者常出现液体超负荷，与不良结局相关。肺部超声（LUS）和生物阻抗谱（BIS）是用于非侵入性容量评估的潜在有用工具。我们评估了这些方法单独或联合应用在估计 AKI 危重症患者 PaO/FiO 比值中的效用。
在一项前瞻性试点观察性研究中，我们纳入了 45 名患者，这些患者在入院时或在重症监护病房住院期间任何时间出现 AKI，AKI 的定义符合 KDIGO 标准。患者在基线和 48 小时时接受 LUS、BIS 和动脉血气检查。
在单变量分析中，PaO/FiO 比值与 B 线评分呈负相关，即使在调整后这种相关性仍然存在。B 线评分的截断值为 17 时，可识别 PaO/FiO < 300 的患者，其敏感性为 76%，特异性为 65%。
LUS 可用于评估肺功能和识别肺水含量增加及 PaO/FiO 比值降低的患者。
