Gibbins Matthew Llewelyn, Otto Quentin, Adrian Clarke Paul, Gurney Stefan
Anaesthetic and Intensive Care Medicine Consultant, Bristol Royal Infirmary (BRI) Bristol, BS2 8HW.
Acute Care Common Stem trainee, Bristol Royal Infirmary (BRI) Bristol, BS2 8HW.
POCUS J. 2021 Nov 23;6(2):109-116. doi: 10.24908/pocus.v6i2.15195. eCollection 2021.
The aim of this retrospective analysis was to assess if serial lung ultrasound assessments in patients with COVID-19 pneumonia, including a novel simplified scoring system, correlate with PaO:FiO ratio, as a marker of disease severity, and patient outcomes. : Patients treated for COVID-19 pneumonia in a tertiary intensive care unit who had a lung ultrasound assessment were included. Standardised assessments of anterior and lateral lung regions were prospectively recorded. A validated lung ultrasound score-of-aeration and a simplified scoring system based on the number of disease-free lung regions were correlated with: PaO:FiO ratio, successful weaning from mechanical ventilation, and status (alive or dead) at discharge. MedCalc© statistical software was used for statistical analysis. : 28 patients (109 assessments) were included. Correlation was seen between score-of-aeration and PaO:FiO ratio (r = -0.61, p<0.0001) and between the simplified scoring system and PaO:FiO ratio (r = 0.52 p<0.0001). Achieving a score-of-aeration of ≤9/24 or ≥2 disease-free regions was associated with successful weaning from mechanical ventilation and survival to ICU discharge (accuracy of 94% and 97% respectively). : Retrospective analysis from this small cohort of patients demonstrates that scores-of-aeration and a simplified scoring system based on the number of disease-free antero-lateral regions from serial LUS assessments correlate with PaO:FiO ratio as a marker of disease severity in patients with COVID-19 pneumonia. In addition, lung ultrasound may help identify patients who will have favourable outcomes.
本回顾性分析的目的是评估对新型冠状病毒肺炎（COVID-19肺炎）患者进行系列肺部超声评估（包括一种新型简化评分系统）是否与作为疾病严重程度标志物的动脉血氧分压与吸入氧浓度比值（PaO₂:FiO₂）以及患者预后相关。纳入在三级重症监护病房接受治疗且进行了肺部超声评估的COVID-19肺炎患者。前瞻性记录前胸部和侧胸部肺区域的标准化评估结果。将经过验证的肺部超声通气评分和基于无病变肺区域数量的简化评分系统与PaO₂:FiO₂、机械通气成功撤机以及出院时状态（存活或死亡）进行关联分析。使用MedCalc©统计软件进行统计分析。纳入28例患者（共109次评估）。通气评分与PaO₂:FiO₂之间存在相关性（r = -0.61，p<0.0001），简化评分系统与PaO₂:FiO₂之间也存在相关性（r = 0.52，p<0.0001）。通气评分≤9/24或无病变区域≥2个与机械通气成功撤机以及重症监护病房（ICU）出院存活相关（准确率分别为94%和97%）。对这一小群患者的回顾性分析表明，系列肺部超声评估得出的通气评分和基于前外侧无病变区域数量的简化评分系统与COVID-19肺炎患者作为疾病严重程度标志物的PaO₂:FiO₂相关。此外，肺部超声可能有助于识别预后良好的患者。
