Department of Intensive Care, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, the Netherlands.
Department of Intensive Care, Maastricht UMC+, Maastricht University, Maastricht, 6229 HX, The Netherlands.
Respir Res. 2024 Jul 8;25(1):268. doi: 10.1186/s12931-024-02893-0.
Lung ultrasound (LUS) in an emerging technique used in the intensive care unit (ICU). The derivative LUS aeration score has been shown to have associations with mortality in invasively ventilated patients. This study assessed the predictive value of baseline and early changes in LUS aeration scores in critically ill invasively ventilated patients with and without ARDS (Acute Respiratory Distress Syndrome) on 30- and 90-day mortality.
This is a post hoc analysis of a multicenter prospective observational cohort study, which included patients admitted to the ICU with an expected duration of ventilation for at least 24 h. We restricted participation to patients who underwent a 12-region LUS exam at baseline and had the primary endpoint (30-day mortality) available. Logistic regression was used to analyze the primary and secondary endpoints. The analysis was performed for the complete patient cohort and for predefined subgroups (ARDS and no ARDS).
A total of 442 patients were included, of whom 245 had a second LUS exam. The baseline LUS aeration score was not associated with mortality (1.02 (95% CI: 0.99 - 1.06), p = 0.143). This finding was not different in patients with and in patients without ARDS. Early deterioration of the LUS score was associated with mortality (2.09 (95% CI: 1.01 - 4.3), p = 0.046) in patients without ARDS, but not in patients with ARDS or in the complete patient cohort.
In this cohort of critically ill invasively ventilated patients, the baseline LUS aeration score was not associated with 30- and 90-day mortality. An early change in the LUS aeration score was associated with mortality, but only in patients without ARDS.
ClinicalTrials.gov, ID NCT04482621.
肺部超声（LUS）是一种在重症监护病房（ICU）中新兴的技术。已经证明衍生的 LUS 充气评分与接受有创通气的患者的死亡率有关。本研究评估了有和没有急性呼吸窘迫综合征（ARDS）的接受有创通气的危重症患者的基线和早期 LUS 充气评分变化对 30 天和 90 天死亡率的预测价值。
这是一项多中心前瞻性观察队列研究的事后分析，该研究纳入了预计至少需要通气 24 小时的 ICU 入院患者。我们将研究对象限制为在基线时接受了 12 区 LUS 检查且主要终点（30 天死亡率）可用的患者。使用逻辑回归分析主要和次要终点。分析在完整的患者队列和预先定义的亚组（ARDS 和非 ARDS）中进行。
共纳入 442 例患者，其中 245 例患者进行了第二次 LUS 检查。基线 LUS 充气评分与死亡率无关（1.02（95%CI：0.99-1.06），p=0.143）。在有和没有 ARDS 的患者中，这一发现没有差异。在没有 ARDS 的患者中，LUS 评分的早期恶化与死亡率相关（2.09（95%CI：1.01-4.3），p=0.046），但在有 ARDS 的患者或在整个患者队列中没有相关性。
在本队列中，接受有创通气的危重症患者的基线 LUS 充气评分与 30 天和 90 天死亡率无关。LUS 充气评分的早期变化与死亡率相关，但仅在没有 ARDS 的患者中。
ClinicalTrials.gov，ID NCT04482621。
