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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >Pulmonary ultrasound scoring system for intubated critically ill patients and its association with clinical metrics and mortality: A prospective cohort study
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Pulmonary ultrasound scoring system for intubated critically ill patients and its association with clinical metrics and mortality: A prospective cohort study

机译：插管患者的肺超声评分系统及其与临床指标与死亡率的关联：展望队列研究

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Abstract Purpose Pulmonary ultrasound (PU) examination at the point‐of‐care can rapidly identify the etiology of acute respiratory failure (ARF) and assess treatment response. The often‐subjective classification of PU abnormalities makes it difficult to document change over time and communicate findings across providers. The study goal was to develop a simple, PU scoring system that would allow for standardized documentation, have high interprovider agreement, and correlate with clinical metrics. Methods In this prospective study of 250 adults intubated for ARF, a PU examination was performed at intubation, 48‐hours later, and at extubation. A total lung score (TLS) was calculated. Clinical metrics and final diagnosis were extracted from the medical record. Results TLS correlated positively with mortality ( P ?=?.03), ventilator hours ( P ?=?.003), intensive care unit, and hospital length of stay ( P ?=?.003, P ?=?.008), and decreasing PaO 2 /FiO 2 ( P ??.001). Agreement of PU findings was very good (kappa?=?0.83). Baseline TLS and subscores differed significantly between ARF categories (nonpulmonary, obstructive, and parenchymal disease). Conclusions A quick, scored, PU examination was associated with clinical metrics, including mortality among a diverse population of patients intubated for ARF. In addition to diagnostic and prognostic information at the bedside, a standardized and quantifiable approach to PU provides objectivity in serial assessment and may enhance communication of findings between providers.
机译：摘要目的肺超声（PU）检查在护理点可以迅速识别急性呼吸衰竭（ARF）的病因并评估治疗反应。 PU异常的经常主观分类使得难以记录随着时间​​的推移和传达提供商的结果。该研究目标是开发一个简单的PU评分系统，可以允许标准化文件，具有高位值协议，与临床指标相关联。该方法在该预热的250例成年人的前瞻性研究中，在插管，48小时后进行PU检查，拔管。计算总肺评分（TLS）。从病历中提取临床指标和最终诊断。结果TLS与死亡率正相关（P？= 03），呼吸机小时（P？= 003），重症监护病房和医院的住宿时间（P？= 003，P？= 008） ，和降低Pao 2 / fiO 2（p≤≤001）。 PU调查结果的协议非常好（Kappa？= 0.83）。基线TLS和亚科尔在ARF类别（非玻璃，阻塞性和实质疾病）之间有显着不同。结论快速，评分，PU检查与临床指标有关，包括预热ARF的多元化患者的死亡率。除了在床边的诊断和预后信息外，PU的标准化和可量化的方法还提供了串行评估的客观性，并可以增强提供商之间的调查结果的沟通。

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