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肺部超声在预测 ARDS 患者肺部通气时间依赖性变化中的临床性能。

Clinical performance of lung ultrasound in predicting time-dependent changes in lung aeration in ARDS patients.

机构信息

Department of Anaesthesia and Critical Care, AOU Città Della Salute E Della Scienza Di Torino, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy.

Department of Surgical Sciences, University of Turin, Turin, Italy.

出版信息

J Clin Monit Comput. 2023 Apr;37(2):473-480. doi: 10.1007/s10877-022-00902-5. Epub 2022 Aug 8.

Abstract

To evaluate whether lung ultrasound is reliable bedside tool to monitor changes of lung aeration at the early and late stages of ARDS. LUS was performed in ARDS patients that underwent at least two consecutive CT scan at ICU admission and at least 1 week after admission. Twelve fields were evaluated and graded from 0 (normal) to 3 (consolidation). Changes of LUS score in twelve fields (ΔLUS) and in four ventral (ΔLUS), intermediate (ΔLUS) and dorsal (ΔLUS) zones were calculated at each time points. Three categories were described: Improve (ΔLUS < 0), Equal (ΔLUS = 0) or Worse (ΔLUS > 0). LUS scores were correlated with total changes in lung CT aeration (ΔCT) and with normally, poorly and not aerated regions (ΔCT, ΔCT and ΔCT, respectively). Eleven patients were enrolled. ΔLUS had significant correlation with ΔCT (r = - 0.74, p < 0.01). ΔLUS, ΔLUS and ΔLUS showed significant correlations with ΔCT (r = - 0.66, r = - 0.69, r = - 0.63, respectively; p < 0.05). Compared to Equal, Improve and Worse categories had significantly higher (p < 0.01) and lower (p < 0.05) ΔCTair values, respectively. Compared to Equal, Improve and Worse categories had lower (p < 0.01) and higher (p < 0.01) ΔCT values, respectively. LUS score had a good correlation with lung CT in detecting changes of lung aeration.

摘要

为了评估肺部超声是否是一种可靠的床边工具,用于监测 ARDS 的早期和晚期肺部通气变化。在 ICU 入院时和入院至少 1 周后,对接受至少两次连续 CT 扫描的 ARDS 患者进行 LUS。评估 12 个区域并分级为 0(正常)至 3(实变)。在每个时间点计算 12 个区域(ΔLUS)和 4 个腹侧(ΔLUS)、中间(ΔLUS)和背侧(ΔLUS)区域的 LUS 评分变化。描述了 3 个类别:改善(ΔLUS<0)、相等(ΔLUS=0)或恶化(ΔLUS>0)。LUS 评分与肺 CT 通气的总变化(ΔCT)以及正常、不良和未通气区域(ΔCT、ΔCT 和 ΔCT,分别)相关。共纳入 11 例患者。ΔLUS 与 ΔCT 呈显著相关(r=-0.74,p<0.01)。ΔLUS、ΔLUS 和 ΔLUS 与 ΔCT 呈显著相关(r=-0.66、r=-0.69、r=-0.63,分别;p<0.05)。与相等相比,改善和恶化类别具有显著更高(p<0.01)和更低(p<0.05)的 ΔCTair 值,分别。与相等相比,改善和恶化类别具有更低(p<0.01)和更高(p<0.01)的 ΔCT 值,分别。LUS 评分与肺 CT 检测肺通气变化具有良好的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8470/10068658/8ef3bf5153b7/10877_2022_902_Fig1_HTML.jpg

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