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• W3028831992 abstract "ObjectiveTo evaluate the value of bedside lung ultrasound for diagnosis of acute respiratory distress syndrome (ARDS) and for assessment of the severity.MethodsFifty patients of both sexes suspected of having ARDS(oxygenation index<300 mmHg) and required lung CT tests and Pulse Indicator Continuous Cardiac Output because of their condition, aged 18-80 yr, were selected.At 24 h after entering ICU, chest CT, lung ultrasound and arterial blood gas analysis were performed to record Extravascular Lung Water Index (EVLWI) and the number of B lines, and lung injury ultrasound score and oxygenation index were calculated.The patients diagnosed with ARDS by chest CT and lung ultrasound were divided into 3 groups: mild group (200 mmHg<oxygenation index≤300 mmHg), moderate group (100 mmHg<oxygenation index≤200 mmHg) and severe group (oxygenation index≤100 mmHg). Kappa consistency analysis was used to assess the consistency between lung ultrasound and chest CT in diagnosis of ARDS.The receiver operating characteristic curves of th number of B lines, EVLWI and lung injury ultrasound score in assessing the severity of ARDS were drawn, and the area under the curve and 95% confidence interval(CI), critical value, sensitivity and specificity were calculated.ResultsForty-six patients were diagnosed as having ARDS by both chest CT and lung ultrasound.There was good consistency (Kappa value 0.648, P<0.01) between chest CT and lung ultrasound in diagnosis of ARDS.There was good consistency (Kappa value 0.788, P<0.01) between lung ultrasound and chest CT in diagnosis of pulmonary consolidation.Lung ultrasound and chest CT were in good agreement (Kappa value 0.825, P<0.01) with each other in diagnosis of pulmonary consolidation in the posterior region.Compared with mild group, the lung injury ultrasound score was significantly increased, and the number of B lines was increased in moderate group, and the lung injury ultrasound score and EVLWI were significantly increased, and the number of B lines was increased in severe group (P<0.05). Compared with moderate group, the lung injury ultrasound score and EVLWI were significantly increased, and the number of B lines was increased in severe group (P<0.05). The area under the curve(95% CI)of the number of B lines in diagnosing severe ARDS was 0.915(0.905-0.935), and the critical value, sensitivity and specificity were 15.5, 78.9% and 85.2%, respectively.The area under the curve (95% CI)of lung injury ultrasound score in diagnosing severe ARDS was 0.856(0.833-0.878), and the critical value, sensitivity and specificity were 25.5, 73.7% and 82.5%, respectively.The area under the curve (95% CI)of EVLWI in diagnosing severe ARDS was 0.907(0.888-0.933), and the critical value, sensitivity and specificity were 15.5, 73.7% and 92.6%, respectively.ConclusionLung ultrasound can be used for diagnosis of ARDS and for evaluation of the severity of ARDS.Key words: Ultrasonography; Respiratory distress syndrome, adult" @default.
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• W3028831992 date "2019-06-20" @default.
• W3028831992 modified "2023-09-23" @default.
• W3028831992 title "Value of bedside lung ultrasound for diagnosis of acute respiratory distress syndrome and for assessment of the severity" @default.
• W3028831992 doi "https://doi.org/10.3760/cma.j.issn.0254-1416.2019.06.024" @default.
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