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基于 BLUE-plus 协议的肺部超声评分与重症监护病房患者的结局和氧合指数相关。

Lung ultrasound score based on the BLUE-plus protocol is associated with the outcomes and oxygenation indices of intensive care unit patients.

机构信息

Department of Critical Care Medicine, Xiangya Hospital, Central South University, National Clinical Research Center for Geriatric Disorders, Hunan Provincial Clinical Research Center for Critical Care Medicine, Changsha, Hunan Province, China.

Department of critical medicine, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, Hebei, China.

出版信息

J Clin Ultrasound. 2021 Sep;49(7):704-714. doi: 10.1002/jcu.23024. Epub 2021 Jun 11.

Abstract

PURPOSE

The primary objective was to demonstrate the relationship between lung ultrasound (LUS) manifestations and the outcomes of intensive care unit (ICU) patients. The secondary objective was to determine the characteristics of LUS manifestations in different subgroups of ICU patients.

METHODS

This prospective multi-center cohort study was conducted in 17 ICUs. A total of 1702 patients admitted between August 31, 2017 and February 16, 2019 were included. LUS was performed according to the bedside lung ultrasound in emergency (BLUE)-plus protocol, and LUS scores were calculated. Data on the outcomes and oxygenation indices were analyzed and compared between different primary indication groups.

RESULTS

The LUS scores were significantly higher for non-survivors than for survivors and were significantly different between the oxygenation index groups, with higher scores in the lower oxygenation index groups. The LUS score was an independent risk factor for the 28-day mortality. The area under the receiver operating characteristic curve was 0.663 for prediction of the 28-day mortality and 0.748 for prediction of an oxygenation index ≤100.

CONCLUSIONS

The LUS score based on the BLUE-plus protocol was an independent risk factor for the 28-day mortality and was important for the prediction of an oxygenation index ≤100. An early LUS score within 24 hours of ICU admission helps predicting the outcome of ICU patients.

摘要

目的

本研究的主要目的是展示肺部超声(LUS)表现与重症监护病房(ICU)患者结局之间的关系。次要目的是确定 ICU 患者不同亚组中 LUS 表现的特征。

方法

这是一项前瞻性多中心队列研究,在 17 个 ICU 中进行。共纳入 2017 年 8 月 31 日至 2019 年 2 月 16 日期间收治的 1702 例患者。根据床边肺部超声紧急(BLUE)-plus 方案进行 LUS 检查,并计算 LUS 评分。分析比较不同主要适应证组之间的结局和氧合指数数据。

结果

非幸存者的 LUS 评分明显高于幸存者,且在氧合指数组之间存在显著差异,氧合指数较低的组 LUS 评分较高。LUS 评分是 28 天死亡率的独立危险因素。预测 28 天死亡率的受试者工作特征曲线下面积为 0.663,预测氧合指数≤100 的面积为 0.748。

结论

基于 BLUE-plus 方案的 LUS 评分是 28 天死亡率的独立危险因素,对于预测氧合指数≤100 很重要。入住 ICU 24 小时内的早期 LUS 评分有助于预测 ICU 患者的结局。

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