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Lung ultrasonography predicts prognosis in acute respiratory distress syndrome

Lung ultrasonography appeared to be a useful and simple method to predict the prognosis of patients with acute respiratory distress syndrome, according to study results.

“Early measurement of lung ultrasound score is a better diagnostic indicator of acute lung injury than late measurement,” researchers wrote. “Compared with other examinations, lung ultrasound is a noninvasive, economic, repeatable, simple, user-friendly, radiation-free bedside method for the prognosis of acute respiratory distress syndrome patients and for determination of the best treatment plan.”

Investigators with Capital Medical University in Beijing evaluated 21 patients with acute respiratory distress syndrome admitted to the intensive care unit who underwent a chest ultrasound.

The researchers examined 12 regions of the lungs, and they used the level of lung aeration to calculate the comprehensive lung ultrasound score.

On the first 3 days after diagnosis, patients also underwent pulse index continuous cardiac output (PiCCO) monitoring to determine the correlation between lung ultrasound B-lines and extravascular lung water indices (EVLWI).

Approximately 62% of patients reached the primary endpoint of mortality, with significantly higher lung ultrasound score and EVLWI values than patients in the survivor group. However, there were no significant differences between the survivor and non-survivor groups on the different days measured.

The investigators observed significant positive linear correlations between lung ultrasound score and EVLWI. They included lung injury score (r² = 0.361), sequential organ failure assessment score (r² = 0.815) and predicted body weight (r² = 0.906).

Regarding PiCCO measurements, the areas under the receiver operating characteristic curve was 0.846 (P < 0.01) for lung ultrasound score and 0.918 (P < 0.01) for EVLW.

The prognostic prediction cut-off for lung ultrasound score was 16.5, the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.