Todur Pratibha, Srikant N, Prakash Prabha
Department of Respiratory Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Karnataka, India.
Can J Respir Ther. 2021 May 19;57:53-59. doi: 10.29390/cjrt-2020-063. eCollection 2021.
Lung ultrasound score (LUS) as well as radiographic assessment of lung edema (RALE) score as calculated from chest radiography (CXR) have been applied to assess Acute Respiratory Distress Syndrome (ARDS) severity. CXRs, which are frequently performed in ARDS patients, pose a greater risk of radiation exposure to patients and health care staff.
The aim of the study was to evaluate if LUS had a better correlation to oxygenation (PaO/FiO) compared with the RALE score in ARDS patients. We also aimed to analyse if there was a correlation between RALE score and LUS. We wanted to determine the LUS and RALE score cut-off, which could predict a prolonged length of intensive care unit (ICU) stay (≥10 days) and survival.
Thirty-seven patients aged above 18 years with ARDS as per Berlin definition and admitted to the ICU were included in the study. It was a retrospective study done over a period of 11 months. On the day of admission to ICU, the global and basal LUS, global and basal RALE score, and PaO /FiO were recorded. Outcome and days of ICU stay were noted.
Global LUS score and PaO/FiO showed the best negative correlation ( -0.491), which was significant ( = 0.002), followed by global RALE score and PaO/FiO ( -0.422, = 0.009). Basal LUS and PaO/FiO also had moderate negative correlation ( = -0.334, = 0.043) followed by basal RALE score and PaO/FiO ( = -0.34, = 0.039). Global RALE score and global LUS did not show a significant correlation. Similarly, there was no significant correlation between basal RALE score and basal LUS. Global and basal LUS as well as global and basal RALE score were not beneficial in predicting either a prolonged length of ICU stay or survival as the area under curve was low.
In ARDS patients, global LUS had the best correlation to oxygenation (PaO/FiO), followed by global RALE score. Basal LUS and basal RALE score also had moderate correlation to oxygenation. However, there was no significant correlation between global LUS and global RALE score as well as between basal LUS and basal RALE score. Global and basal LUS as well as global and basal RALE scores were not able to predict a prolonged ICU stay or survival in ARDS patients.
肺部超声评分（LUS）以及根据胸部X线摄影（CXR）计算得出的肺水肿影像学评估（RALE）评分已被用于评估急性呼吸窘迫综合征（ARDS）的严重程度。在ARDS患者中经常进行的CXR检查，会给患者和医护人员带来更大的辐射暴露风险。
本研究的目的是评估ARDS患者中，与RALE评分相比，LUS与氧合（PaO₂/FiO₂）的相关性是否更好。我们还旨在分析RALE评分与LUS之间是否存在相关性。我们想确定能够预测重症监护病房（ICU）住院时间延长（≥10天）和生存情况的LUS和RALE评分临界值。
纳入37例年龄在18岁以上、符合柏林定义的ARDS且入住ICU的患者。这是一项为期11个月的回顾性研究。在入住ICU当天，记录整体和基础LUS、整体和基础RALE评分以及PaO₂/FiO₂。记录结局和ICU住院天数。
整体LUS评分与PaO₂/FiO₂显示出最佳的负相关性（-0.491），具有显著性（P = 0.002），其次是整体RALE评分与PaO₂/FiO₂（-0.422，P = 0.009）。基础LUS与PaO₂/FiO₂也有中度负相关性（r = -0.334，P = 0.043），其次是基础RALE评分与PaO₂/FiO₂（r = -0.34，P = 0.039）。整体RALE评分与整体LUS未显示出显著相关性。同样，基础RALE评分与基础LUS之间也没有显著相关性。整体和基础LUS以及整体和基础RALE评分在预测ICU住院时间延长或生存方面并无益处，因为曲线下面积较低。
在ARDS患者中，整体LUS与氧合（PaO₂/FiO₂）的相关性最佳
