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线性和扇型探头手持式肺部超声在机械通气 ICU 患者中的比较。

Comparison of Linear and Sector Array Probe for Handheld Lung Ultrasound in Invasively Ventilated ICU Patients.

机构信息

Department of Intensive Care, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, the Netherlands.

Department of Intensive Care, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, the Netherlands.

出版信息

Ultrasound Med Biol. 2020 Dec;46(12):3249-3256. doi: 10.1016/j.ultrasmedbio.2020.08.016. Epub 2020 Sep 19.

Abstract

International guidelines do not recommend a specific probe for assessment of lung aeration using lung ultrasound (LUS). The aim of this study was to assess the concordance between linear and sector array probes of a handheld ultrasound device in assessment of lung aeration in invasively ventilated intensive care unit patients. This study included intensive care unit patients who were expected to be ventilated for longer than 24 h. A 12-region LUS exam was performed with a linear and a sector array probe. In each image, the LUS aeration score and number of B-lines were determined. Adding the LUS aeration scores of all regions resulted in a global LUS aeration score. Agreement between the two probes was calculated using intra-class correlation coefficients (ICCs). A total of 30 LUS exams were performed in 19 patients, resulting in a total of 328 pairs of images. Twenty-nine pairs of images were excluded from analysis because the images from the linear probe could not be scored. ICCs calculated for the remaining images revealed good concordance the LUS aeration scores for individual images (ICC = 0.73, 95% confidence interval 0.67-0.78), number of B-lines (ICC = 0.79, 95% confidence interval 0.72-0.83) and global LUS aeration score (ICC = 0.74, 95% confidence interval 0.52-0.87). In conclusion, there is good concordance between linear and sector array probes of a handheld ultrasound device in assessment of lung aeration patterns in mechanically ventilated intensive care unit patients. However, in roughly 10% of the images acquired using the linear probe, the aeration pattern could not be scored.

摘要

国际指南不建议使用肺部超声(LUS)评估肺部通气时使用特定的探头。本研究旨在评估手持式超声设备的线性和扇形探头在评估机械通气重症监护病房患者肺部通气中的一致性。本研究纳入预计通气时间超过 24 小时的重症监护病房患者。使用线性和扇形探头进行 12 区 LUS 检查。在每个图像中,确定 LUS 充气评分和 B 线数量。将所有区域的 LUS 充气评分相加得出总 LUS 充气评分。使用组内相关系数(ICC)计算两种探头之间的一致性。在 19 名患者中进行了 30 次 LUS 检查,共产生了 328 对图像。由于无法对线性探头的图像进行评分,因此排除了 29 对图像进行分析。对其余图像计算的 ICC 显示,单个图像的 LUS 充气评分(ICC=0.73,95%置信区间 0.67-0.78)、B 线数量(ICC=0.79,95%置信区间 0.72-0.83)和总 LUS 充气评分(ICC=0.74,95%置信区间 0.52-0.87)具有良好的一致性。总之,在评估机械通气重症监护病房患者肺部充气模式时,手持式超声设备的线性和扇形探头之间具有良好的一致性。然而,在使用线性探头采集的大约 10%的图像中,无法对充气模式进行评分。

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