Rendón-Ramírez Erick Joel, Morales-García Andrés Mauricio, Rendón-Pérez Adrián, Nañez-Terreros Homero, Solis Ricardo Cesar, Magaña-García Alexandra Daniela, Medrano-Juárez Samantha, Caloca-Estrada Jose Francisco, Mercado-Longoria Roberto, Leija-Herrera Jorge Eduardo, Porcel José M
Servicio de Neumología y Cuidados Intensivos,, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, CIPTR Monterrey, NL MEX.
Departamento de Medicina Interna, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León Monterrey, NL MEX.
POCUS J. 2024 Nov 15;9(2):55-61. doi: 10.24908/pocus.v9i2.17293. eCollection 2024.
To analyze the association between pleural effusion detected by chest point of care ultrasound (POCUS) and clinical outcomes in patients with septic shock admitted to an intensive care unit (ICU). A prospective evaluation of ICU patients with septic shock in whom chest POCUS was performed during the first 24 hours of diagnosis to identify the presence and characteristics of pleural effusion. Of 45 patients with septic shock, 17 (38%) had pleural effusion. Mortality (13 vs 17 patients, p=0.44), as well as length of stay in ICU (11.0 vs 6.5 days, p=0.161) were similar among groups. However, there was a significant difference in the modified Nutrition Risk in Critically Ill (mNUTRIC) score between the pleural effusion (5.82±1.13) and non-pleural effusion groups (4.00±2.39, p=0.001). In addition, patients with pleural effusion required more days on mechanical ventilation than those without pleural effusion (10 vs 7, p=0.04). A subgroup analysis of chest POCUS characteristics between surviving and non-surviving patients with pleural effusion identified a higher median size of pleural effusion in the non-surviving group (3±2.16 cm vs 1.9±0.6, p=0.01). Pleural effusion in patients with septic shock is associated with high mNUTRIC scores and more days on mechanical ventilation. The larger the pleural effusion, the lower the survival rate.
分析重症监护病房（ICU）收治的感染性休克患者经床旁胸部超声（POCUS）检测出的胸腔积液与临床结局之间的关联。对诊断后24小时内接受胸部POCUS检查以确定胸腔积液的存在及特征的感染性休克ICU患者进行前瞻性评估。45例感染性休克患者中，17例（38%）有胸腔积液。两组患者的死亡率（13例 vs 17例，p = 0.44）以及ICU住院时间（11.0天 vs 6.5天，p = 0.161）相似。然而，胸腔积液组（5.82±1.13）与无胸腔积液组（4.00±2.39，p = 0.001）的改良重症患者营养风险（mNUTRIC）评分存在显著差异。此外，有胸腔积液的患者机械通气天数比无胸腔积液的患者更多（10天 vs 7天，p = 0.04）。对有胸腔积液的存活患者和非存活患者的胸部POCUS特征进行亚组分析发现，非存活组胸腔积液的中位大小更高（3±2.16 cm vs 1.9±0.6，p = 0.01）。感染性休克患者的胸腔积液与高mNUTRIC评分及更多的机械通气天数相关。胸腔积液越大，生存率越低。
