Department of Emergency Internal Medicine, The First Affiliated Hospital of Bengbu Medical College, No. 287 Changhuai Road, Bengbu, 233004, Anhui, China.
Eur J Med Res. 2022 Feb 22;27(1):27. doi: 10.1186/s40001-022-00652-9.
Acute respiratory distress syndrome (ARDS) has been a prevalent disease in ICU with mortality of up to 27-45%. A considerable proportion of extubated ARDS patients passing spontaneous breathing trial (SBT) still requires reintubation.
Lung ultrasonography (LUS) was used to predict the success rate of extubation. Ninety-two patients passing the 60-min SBT were included in this prospective research. Their clinical characters including LUS, APACHE II, SOFA, CPIS, EVLWI and PaO/FiO were collected before the SBT. Another two LUS assessments were performed at the end of and 4 h after SBT. LUS results were evaluated and scored by two independent experts, and the correlations of LUS scores, APACHE-II scores, SOFA scores, CPIS and EVLWI with the success rate of extubation and rate of reintubation were analyzed.
Failed weaning and reintubation of ARDS patients were correlated with higher LUS scores both before and after SBT. Post-extubation distress was correlated with higher APACHE-II scores, SOFA scores, CPIS and EVLWI before SBT. There were positive correlations between the LUS score and APACHE-II score, SOFA score, CPIS and EVLWI before SBT, respectively.
LUS score measured at the end of 60-min SBT could be used to predict post-extubation distress in ARDS patients.
急性呼吸窘迫综合征（ARDS）是 ICU 中的常见病，死亡率高达 27-45%。相当一部分通过自主呼吸试验（SBT）拔管的 ARDS 患者仍需要再次插管。
使用肺部超声（LUS）来预测拔管成功率。这项前瞻性研究纳入了 92 例通过 60 分钟 SBT 的患者。在 SBT 前收集了他们的临床特征，包括 LUS、APACHE II、SOFA、CPIS、EVLWI 和 PaO/FiO。在 SBT 结束时和 4 小时后进行了另外两次 LUS 评估。由两位独立专家对 LUS 结果进行评估和评分，并分析 LUS 评分、APACHE-II 评分、SOFA 评分、CPIS 和 EVLWI 与拔管成功率和再插管率的相关性。
ARDS 患者的撤机失败和再插管与 SBT 前后的 LUS 评分较高有关。撤机后呼吸困难与 SBT 前较高的 APACHE-II 评分、SOFA 评分、CPIS 和 EVLWI 有关。LUS 评分与 SBT 前的 APACHE-II 评分、SOFA 评分、CPIS 和 EVLWI 之间呈正相关。
在 60 分钟 SBT 结束时测量的 LUS 评分可用于预测 ARDS 患者撤机后的呼吸困难。
