{"title":"机械通气患者肺超声评分与氧合及肺力学关系的观察性研究。","authors":"Nishant Kumar, Ayushi Yadav, Maitree Pandey","doi":"10.4103/ija.ija_771_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>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<sub>2</sub> in mmHg) to fractional inspired oxygen (FiO<sub>2</sub>)] and respiratory mechanics (compliance and resistance).</p><p><strong>Methods: </strong>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<sub>2</sub>/FiO<sub>2</sub> ratio of <200.</p><p><strong>Results: </strong>LUSS showed a negative correlation with PaO<sub>2</sub>/FiO<sub>2</sub> ratio (ρ = 0.827, <i>P</i> < 0.001) and lung compliance (ρ = 0.634, <i>P</i> < 0.001) but a positive linear correlation with lung resistance (ρ = 0.735, <i>P</i> < 0.001). LUSS > 12 predicts a PaO<sub>2</sub>/FiO<sub>2</sub> ratio of <200 with a specificity of 85.7% and a sensitivity of 97.37% (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 12","pages":"1062-1067"},"PeriodicalIF":2.9000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812509/pdf/","citationCount":"0","resultStr":"{\"title\":\"Relationship of lung ultrasound score with oxygenation and pulmonary mechanics in mechanically ventilated patients: An observational study.\",\"authors\":\"Nishant Kumar, Ayushi Yadav, Maitree Pandey\",\"doi\":\"10.4103/ija.ija_771_24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>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<sub>2</sub> in mmHg) to fractional inspired oxygen (FiO<sub>2</sub>)] and respiratory mechanics (compliance and resistance).</p><p><strong>Methods: </strong>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<sub>2</sub>/FiO<sub>2</sub> ratio of <200.</p><p><strong>Results: </strong>LUSS showed a negative correlation with PaO<sub>2</sub>/FiO<sub>2</sub> ratio (ρ = 0.827, <i>P</i> < 0.001) and lung compliance (ρ = 0.634, <i>P</i> < 0.001) but a positive linear correlation with lung resistance (ρ = 0.735, <i>P</i> < 0.001). LUSS > 12 predicts a PaO<sub>2</sub>/FiO<sub>2</sub> ratio of <200 with a specificity of 85.7% and a sensitivity of 97.37% (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":13339,\"journal\":{\"name\":\"Indian Journal of Anaesthesia\",\"volume\":\"68 12\",\"pages\":\"1062-1067\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812509/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Anaesthesia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/ija.ija_771_24\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Anaesthesia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/ija.ija_771_24","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/3 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景和目的:少于三条b线表明肺通气正常,而多条b线表明中度至重度通气不足。本研究旨在发现肺超声评分(LUSS)与氧合[动脉氧分压(PaO2 in mmHg)与分次吸入氧(FiO2)之比]和呼吸力学(顺应性和阻力)的相关性。方法:对50例年龄18 ~ 60岁、需机械通气至少24小时的患者进行101次肺部超声检查。采用12个区域法,计算每个肋间隙b线数,计算LUSS。同时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。结果:LUSS与PaO2/FiO2比值(ρ = 0.827, P < 0.001)和肺顺应性(ρ = 0.634, P < 0.001)呈负相关,与肺阻力呈线性正相关(ρ = 0.735, P < 0.001)。LUSS bbb12预测PaO2/FiO2比值P < 0.001)。结论:LUSS是一种简便、有效的测量机械通气患者肺参数的床边工具。它与氧合、肺顺应性和阻力有中度相关性。
Relationship of lung ultrasound score with oxygenation and pulmonary mechanics in mechanically ventilated patients: An observational study.
Background and aims: 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 (PaO2 in mmHg) to fractional inspired oxygen (FiO2)] and respiratory mechanics (compliance and resistance).
Methods: 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 PaO2/FiO2 ratio of <200.
Results: LUSS showed a negative correlation with PaO2/FiO2 ratio (ρ = 0.827, P < 0.001) and lung compliance (ρ = 0.634, P < 0.001) but a positive linear correlation with lung resistance (ρ = 0.735, P < 0.001). LUSS > 12 predicts a PaO2/FiO2 ratio of <200 with a specificity of 85.7% and a sensitivity of 97.37% (P < 0.001).
Conclusion: 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.