Kumar Nishant, Yadav Ayushi, Pandey Maitree
Anaesthesiology and Critical Care, Lady Hardinge Medical College and Associated Hospitals, New Delhi, Delhi, India.
Indian J Anaesth. 2024 Dec;68(12):1062-1067. doi: 10.4103/ija.ija_771_24. Epub 2024 Dec 3.
Less than three B-lines indicate normal lung aeration, whereas multiple B-lines indicate moderate-to-severe loss of aeration. This study aimed to find a correlation between lung ultrasound score (LUSS) with oxygenation [ratio of arterial oxygen partial pressure (PaO in mmHg) to fractional inspired oxygen (FiO)] and respiratory mechanics (compliance and resistance).
In total, 101 lung ultrasounds were performed in 50 patients aged 18-60 years, requiring mechanical ventilation for at least 24 hours. Twelve region methods was used, the number of B-lines were counted in each intercostal space, and LUSS was calculated. In addition, ventilator and arterial blood gas (ABG) parameters were noted. The correlation between these variables with LUSS was evaluated using Spearman's coefficient. A receiver operating curve analysis was performed to find the cut-off value of LUSS to predict a PaO/FiO ratio of <200.
LUSS showed a negative correlation with PaO/FiO ratio (ρ = 0.827, < 0.001) and lung compliance (ρ = 0.634, < 0.001) but a positive linear correlation with lung resistance (ρ = 0.735, < 0.001). LUSS > 12 predicts a PaO/FiO ratio of <200 with a specificity of 85.7% and a sensitivity of 97.37% ( < 0.001).
LUSS is an easy and effective bedside tool for measuring lung parameters in mechanically ventilated patients. It correlates moderately with oxygenation, lung compliance, and resistance.
少于三条B线提示肺通气正常,而多条B线提示中度至重度通气丧失。本研究旨在寻找肺超声评分(LUSS)与氧合[动脉血氧分压(以mmHg为单位的PaO)与吸入氧分数(FiO)之比]及呼吸力学(顺应性和阻力)之间的相关性。
对50例年龄在18至60岁之间、需要机械通气至少24小时的患者共进行了101次肺部超声检查。采用十二区域法,在每个肋间间隙计数B线数量,并计算LUSS。此外,记录呼吸机和动脉血气(ABG)参数。使用Spearman系数评估这些变量与LUSS之间的相关性。进行受试者工作特征曲线分析以确定LUSS预测PaO/FiO比值<200的临界值。
LUSS与PaO/FiO比值呈负相关(ρ = 0.827,<0.001)和肺顺应性呈负相关(ρ = 0.634,<0.001),但与肺阻力呈正线性相关(ρ = 0.735,<0.001)。LUSS>12预测PaO/FiO比值<200,特异性为85.7%,敏感性为97.37%(<0.001)。
LUSS是一种用于测量机械通气患者肺部参数的简便有效的床旁工具。它与氧合、肺顺应性和阻力呈中度相关。