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肺部超声评分作为机械通气相关性肺炎患者临床严重程度和预后的预测指标

Lung Ultrasound Score as a Predictor of Clinical Severity and Prognosis in Patients of Ventilator-associated Pneumonia.

作者信息

Panda Sagarika, Agarwal Ankit, Mishra Shakti Bedanta, Jain Gaurav, Talawar Praveen

机构信息

Department of Critical Care Medicine, IMS and Sum Hospital, Bhubaneswar, Odisha, India.

Department of Anesthesiology Critical Care, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

出版信息

Indian J Crit Care Med. 2024 Nov;28(11):1009-1014. doi: 10.5005/jp-journals-10071-24828. Epub 2024 Oct 30.

Abstract

BACKGROUND

To estimate a correlation between change in lung ultrasound aeration score (LUSS) and mortality in patients with ventilator-associated pneumonia.

MATERIALS AND METHODS

We conducted a prospective observational study in which lung ultrasound, the partial pressure of arterial oxygen to fraction of inspired oxygen ratio (PaO/FiO ratio), and static lung compliance were performed for five consecutive days since the diagnosis of ventilator-associated pneumonia (day 1-5) in a 20-bed multidisciplinary intensive care unit in at a tertiary care academic institute in Northern India. A hundred and seventeen ventilated patients were studied for the first 5 days after ventilator-associated pneumonia (VAP) development. Lung ultrasounds were performed with an ultrasonography machine using a round-tipped probe of 2-5 MHz at six different areas of each hemithorax, which includes superior and inferior in anterior, lateral, and posterior lung fields. Patients with a decreased LUSS of 2 were labeled as responders. A decrease of LUSS of less than 2 or an increase of LUSS were leveled as nonresponders.

RESULTS

The correlation between the change in LUSS between days 1 and 5 was significant with 28-day mortality (26.3% in responders vs 87.8% nonresponses with < 0.001).

CONCLUSION

The responders to treatment for VAP described by LUSS had lower mortality than non-responders.

HOW TO CITE THIS ARTICLE

Panda S, Agarwal A, Mishra SB, Jain G, Talawar P. Lung Ultrasound Score as a Predictor of Clinical Severity and Prognosis in Patients of Ventilator-associated Pneumonia. Indian J Crit Care Med 2024;28(11):1009-1014.

摘要

背景

评估呼吸机相关性肺炎患者肺部超声通气评分(LUSS)变化与死亡率之间的相关性。

材料与方法

我们在印度北部一家三级医疗学术机构的一个拥有20张床位的多学科重症监护病房进行了一项前瞻性观察研究,自诊断呼吸机相关性肺炎起连续5天(第1 - 5天)进行肺部超声检查、动脉血氧分压与吸入氧分数比(PaO/FiO比)以及静态肺顺应性检测。对117例机械通气患者在呼吸机相关性肺炎(VAP)发生后的前5天进行研究。使用超声检查仪,采用2 - 5 MHz的圆头探头,在每个半胸的六个不同区域进行肺部超声检查,这些区域包括前、外侧和后肺野的上、下部。LUSS下降≥2的患者被标记为反应者。LUSS下降<2或LUSS升高的患者被归类为无反应者。

结果

第1天和第5天LUSS的变化与28天死亡率之间存在显著相关性(反应者为26.3%,无反应者为87.8%,P<0.001)。

结论

LUSS所描述的VAP治疗反应者的死亡率低于无反应者。

如何引用本文

Panda S, Agarwal A, Mishra SB, Jain G, Talawar P. Lung Ultrasound Score as a Predictor of Clinical Severity and Prognosis in Patients of Ventilator-associated Pneumonia. Indian J Crit Care Med 2024;28(11):1009 - 1014.

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