Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, People's Republic of China.
Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310016, People's Republic of China.
Clin Interv Aging. 2024 Feb 19;19:313-322. doi: 10.2147/CIA.S438714. eCollection 2024.
The lung ultrasound score was developed for rapidly assessing the extent of lung ventilation, and it can predict failure to wean various types of patients off mechanical ventilation. Whether it is also effective for COVID-19 patients is unclear.
This single-center, prospective, observational study was conducted to assess the ability of the 12-region lung ultrasound score to predict failure to wean COVID-19 patients off ventilation. In parallel, we assessed whether right hemidiaphragmatic excursion or previously published predictors of weaning failure can apply to these patients. Predictive ability was assessed in terms of the area under the receiver operating characteristic curve (AUC).
The mean age of the 35 patients in the study was (75 ± 9) years and 12 patients (37%) could not be weaned off mechanical ventilation. The lung ultrasound score predicted these failures with an AUC of 0.885 (95% CI 0.770-0.999, < 0.001), and a threshold score of 10 provided specificity of 72.7% and sensitivity of 92.3%. AUCs were lower for previously published predictors of weaning failure, and right hemidiaphragmatic excursion did not differ significantly between the two groups.
The lung ultrasound score can accurately predict failure to wean critically ill COVID-19 patients off mechanical ventilation, whereas assessment of right hemidiaphragmatic excursion does not appear helpful in this regard.
肺部超声评分是为了快速评估肺部通气程度而开发的，它可以预测各种类型的患者脱机机械通气失败。对于 COVID-19 患者是否有效尚不清楚。
本单中心前瞻性观察性研究旨在评估 12 区肺部超声评分预测 COVID-19 患者脱机失败的能力。同时，我们评估了右膈肌移动度或以前发表的脱机失败预测因子是否适用于这些患者。预测能力通过接受者操作特征曲线下面积（AUC）来评估。
研究中 35 例患者的平均年龄为（75±9）岁，12 例（37%）患者不能脱机机械通气。肺部超声评分预测这些失败的 AUC 为 0.885（95%CI 0.770-0.999， < 0.001），阈值评分为 10 时，特异性为 72.7%，敏感性为 92.3%。以前发表的脱机失败预测因子的 AUC 较低，两组之间右膈肌移动度没有显著差异。
肺部超声评分可以准确预测重症 COVID-19 患者脱机机械通气失败，而右膈肌移动度评估在这方面似乎没有帮助。
