Department of Paediatrics, The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Department of Paediatrics, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Pediatr Pulmonol. 2020 Mar;55(3):729-739. doi: 10.1002/ppul.24635. Epub 2020 Jan 9.
Increases in extravascular lung water (EVLW) can lead to respiratory failure. This study aimed to investigate whether the B-line score (BLS) was correlated with the EVLW content determined by the lung wet/dry ratio in a rabbit model.
A total of 45 New Zealand rabbits were randomly assigned to nine groups. Among the animals, models of various lung water content levels were induced by the infusion of different volumes of warm sterile normal saline (NS) via the endotracheal tube. The arterial blood gas, spontaneous respiratory rate, and PaO /FiO ratio were detected before and after infusion. In addition, the B-lines were determined before and immediately after infusion in each group. Finally, both lungs were resected to determine the wet/dry ratio. In addition, all lung specimens were analyzed histologically, and EVLW was quantified using the BLS based on the number and confluence of B-lines in the intercostal space.
The BLS increased with increasing infusion volume. The BLS was statistically correlated with the wet/dry ratio (r = .946) and with the PaO /FiO ratio (r = .916). Furthermore, a repeatability study was performed for the lung ultrasound (LUS) technology (Bland-Altman plots), and the results suggest that LUS had favorable intraobserver and interobserver reproducibility.
This study is the first to suggest that the BLS can serve as a sensitive, quantitative, noninvasive, and real-time indicator of EVLW in a rabbit model of lung water accumulation. Notably, the BLS displayed an obvious correlation with the experimental gravimetry results and could also be used to predict the pulmonary oxygenation status.
肺血管外水（EVLW）的增加可导致呼吸衰竭。本研究旨在探讨兔模型中 B 线评分（BLS）与肺湿/干比测定的 EVLW 含量是否相关。
共 45 只新西兰兔随机分为 9 组。通过经气管内管输注不同体积的温无菌生理盐水（NS），诱导各种肺水含量水平的动物模型。在输注前后检测动脉血气、自主呼吸频率和 PaO/FiO 比。此外，在每组输注前后测量 B 线。最后，切除双肺以确定湿/干比。此外，对所有肺标本进行组织学分析，并根据肋间 B 线的数量和融合度，使用 BLS 定量 EVLW。
BLS 随输注量的增加而增加。BLS 与湿/干比（r =.946）和 PaO/FiO 比（r =.916）呈统计学相关。此外，对肺部超声（LUS）技术（Bland-Altman 图）进行了重复性研究，结果表明 LUS 具有良好的观察者内和观察者间可重复性。
本研究首次表明，BLS 可作为兔肺水积聚模型中 EVLW 的敏感、定量、无创和实时指标。值得注意的是，BLS 与实验重力法结果有明显相关性，也可用于预测肺氧合状态。
