scholarly journals Lung ultrasound predicts acute respiratory distress syndrome in patients with paraquat intoxication

2017 ◽  
Vol 24 (6) ◽  
pp. 275-281 ◽  
Author(s):  
Xiao Lu ◽  
DingQian Wu ◽  
YuZhi Gao ◽  
Mao Zhang
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Organ Failure ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Lung Aeration ◽  
Failure Assessment ◽  
Ultrasound Score ◽  
The Impact

Objective: We assessed the evolution of lung aeration by “Lung Ultrasound Score” to predict the acute respiratory distress syndrome in patients with paraquat intoxication. Methods: Patients with paraquat intoxication treated in the intensive care unit were reviewed. Patients who had been assessed by transthoracic lung ultrasound at 3 time points as day 1, day 3, and day 7 after the treatment were analyzed. Lung aeration was represented by the lung ultrasound score. The relationship of the score with the development of acute respiratory distress syndrome was evaluated. Results: There were 50 patients included. On day 7, 18 patients developed the acute respiratory distress syndrome. The acute respiratory distress syndrome patients demonstrated a higher mortality rate than that for the non-acute respiratory distress syndrome patients (88.9% vs 31.5%, p < 0.001). In addition, the acute respiratory distress syndrome patients not only had a higher creatinine level (p < 0.001), and Sepsis-related Organ Failure Assessment 48-h scores (p < 0.001), and a longer time to gastric lavage but also suffered from a lower PaO2/FiO2 (p < 0.001) and a higher lung ultrasound score (p < 0.001) compared to those in the non-acute respiratory distress syndrome patients. The decrease in PaO2/FiO2 between day 3 and day 7 correlated with the increase in lung ultrasound score between day 3 and day 7. There was also a significant correlation between the Sepsis-related Organ Failure Assessment score and lung ultrasound score in acute respiratory distress syndrome patient on day 7. Conclusion: The transthoracic lung ultrasound may be a useful tool for lung aeration assessment on patients with paraquat intoxication receiving treatment. Further studies are needed to evaluate the impact of this screening strategy on predicting acute respiratory distress syndrome.

scholarly journals Lung Ultrasound Score Assessing the Pulmonary Edema in Pediatric Acute Respiratory Distress Syndrome Received Continuous Hemofiltration Therapy: A Prospective Observational Study

2020 ◽  
Author(s):  
Fei Wang ◽  
Chunxia Wang ◽  
Jingyi Shi ◽  
Yijun Shan ◽  
Huijie Miao ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Renal Replacement Therapy ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Continuous Renal Replacement Therapy ◽  
Pulmonary Edema ◽  
Replacement Therapy ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Ultrasound Score

Abstract Background: Lung ultrasound score is a potential method for determining pulmonary edema in acute respiratory distress syndrome. Continuous renal replacement therapy has become the preferred modality to manage fluid overload during acute respiratory distress syndrome. The aim of this study was to evaluate the value of lung ultrasound score on assessing the effects of continuous renal replacement therapy on pulmonary edema and pulmonary function in pediatric acute respiratory distress syndrome. Methods: We conducted a prospective study in children with moderate to severe acute respiratory distress syndrome in a tertiary university pediatric intensive care unit from January 2016 to December 2018. Lung ultrasound score was measured within 2 hours identified acute respiratory distress syndrome as the value of 1st，and the following three days as the 2nd, 3rd, and 4th.Results: A total of 70 patients with acute respiratory distress syndrome were enrolled in this study. Thirty-seven patients received continuous renal replacement therapy (CRRT group) and thirty-three patients treated by conventional therapy (Non-CRRT group). The 1st lung ultrasound score in CRRT group were significantly higher than Non-CRRT group (P < 0.05), but the lung ultrasound score decreased gradually following the continuous renal replacement therapy (P < 0.001). Lung ultrasound score was significantly correlated with PaO2/FiO2, dynamic lung compliance, and oxygen index based on 1st to 4th values (all P<0.001). Lung ultrasound score decreased from 22 (18 - 25) to 15 (13 - 18) and PaO2/FiO2 promoted from 106.00 (96.00 - 121.50) mmHg to 160.00 (142.50 - 173.00) mmHg after continuous renal replacement therapy for four days (both P < 0.001).Conclusions: Lung ultrasound score is closely correlated with PaO2/FiO2, oxygen index and dynamic lung compliance in pediatric acute respiratory distress syndrome. The improvement of pulmonary edema in patient with acute respiratory distress syndrome received continuous renal replacement therapy can be assessed by the lung ultrasound score.Trial registration: CCTR, ChiCTR-ONC-16009698. Registered 1 November 2016, prospectively registered, http://www.chictr.org.cn/edit.aspx?pid=16535&htm=4. This study adheres to CONSORT guidelines.

scholarly journals Lung ultrasound score assessing the pulmonary edema in pediatric acute respiratory distress syndrome received continuous hemofiltration therapy: A prospective observational study

2020 ◽  
Author(s):  
Fei Wang ◽  
Chunxia Wang ◽  
Jingyi Shi ◽  
Yijun Shan ◽  
Huijie Miao ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Potential Method ◽  
Lung Compliance ◽  
Continuous Hemofiltration ◽  
Ultrasound Score

Abstract Background: Lung ultrasound score is a potential method for determining pulmonary edema in acute respiratory distress syndrome (ARDS). Continuous renal replacement therapy (CRRT) has become the preferred modality to manage fluid overload during ARDS. The aim of this study was to evaluate the value of lung ultrasound (LUS) score on assessing the effects of CRRT on pulmonary edema and pulmonary function in pediatric ARDS. Methods: We conducted a prospective cohort study in 70 children with moderate to severe ARDS in a tertiary university pediatric intensive care unit from January 2016 to December 2018. 37 patients received CRRT (CRRT group) and 33 patients treated by conventional therapy (Non-CRRT group). LUS score was measured within 2 hours identified ARDS as the value of 1st，and the following three days as the 2nd, 3rd, and 4th. We used Spearman correlation analysis to develop the relationship between LUS score and PaO2/FiO2, dynamic lung compliance (Cdyn), PaCO2, oxygen index (OI), as well as between the change in daily fluid balance volume and the change in LUS score during CRRT.Results: The 1st lung ultrasound score in CRRT group were significantly higher than Non-CRRT group (P < 0.001), but the lung ultrasound score decreased gradually following CRRT (P < 0.001). LUS score was significantly correlated with PaO2/FiO2 (1st: r =-0.800, 2nd: r =-0.807, 3rd: r =-0.703, 4th: r =-0.584), Cdyn (1st: r =-0.757, 2nd: r =-0.906, 3rd: r =-0.885, 4th: r =-0.834), and OI (1st: r =0.678, 2nd: r =0.689, 3rd: r =0.486, 4th: r =0.324) based on 1st to 4th values (all P<0.05). LUS score decreased from 22 (18 - 25) to 15 (13 - 18) and PaO2/FiO2 promoted from 106.00 (96.00 - 121.50) mmHg to 160.00 (142.50 - 173.00) mmHg after CRRT for four days (both P < 0.001).Conclusions: LUS score is significantly correlated with lung function parameters in pediatric ARDS. The improvement of pulmonary edema in patient with ARDS received CRRT can be assessed by the LUS score.

scholarly journals Lung ultrasound score assessing the pulmonary edema in pediatric acute respiratory distress syndrome received continuous hemofiltration therapy: A prospective observational study

2020 ◽  
Author(s):  
Fei Wang ◽  
Chunxia Wang ◽  
Jingyi Shi ◽  
Yijun Shan ◽  
Huijie Miao ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Pediatric Intensive Care ◽  
Potential Method ◽  
Continuous Hemofiltration ◽  
Ultrasound Score

Abstract Background: Lung ultrasound score is a potential method for determining pulmonary edema in acute respiratory distress syndrome (ARDS). Continuous renal replacement therapy (CRRT) has become the preferred modality to manage fluid overload during ARDS. The aim of this study was to evaluate the value of lung ultrasound (LUS) score on assessing the effects of CRRT on pulmonary edema and pulmonary function in pediatric ARDS. Methods: We conducted a prospective cohort study in 70 children with moderate to severe ARDS in a tertiary university pediatric intensive care unit from January 2016 to December 2019. 37 patients received CRRT (CRRT group) and 33 patients treated by conventional therapy (Non-CRRT group). LUS score was measured within 2 hours identified ARDS as the value of 1st，and the following three days as the 2nd, 3rd, and 4th. We used Spearman correlation analysis to develop the relationship between LUS score and parameters related to respiratory dynamics, clinical outcomes as well as daily fluid balance during the first four days after ARDS diagnosed.Results: The 1st LUS score in CRRT group were significantly higher than Non-CRRT group (P < 0.001), but the LUS score decreased gradually following CRRT (P < 0.001). LUS score was significantly correlated with Cdyn (1st: r =-0.757, 2nd: r =-0.906, 3rd: r =-0.885, 4th: r =-0.834), OI (1st: r =0.678, 2nd: r =0.689, 3rd: r =0.486, 4th: r =0.324) based on 1st to 4th values (all P <0.05). Only values of the 3rd and 4th LUS score after ARDS diagnosed were correlated with duration of mechanical ventilation [1st: r = 0.167, P = 0.325; 2nd: r = 0.299, P = 0.072; 3rd: r = 0.579, P < 0.001; 4th: r = 0.483, P = 0.002]. LUS score decreased from 22 (18 - 25) to 15 (13 - 18) and OI decreased from 15.92 (14.07 -17.73) to 9.49 (8.70-10.58) after CRRT for four days (both P < 0.001).Conclusions: LUS score is significantly correlated with lung function parameters in pediatric ARDS. The improvement of pulmonary edema in patient with ARDS received CRRT can be assessed by the LUS score.Trial registration: CCTR, ChiCTR-ONC-16009698. Registered 1 November 2016, prospectively registered, http://www.chictr.org.cn/edit.aspx?pid=16535&htm=4. This study adheres to CONSORT guidelines.

scholarly journals Lung ultrasound score assessing the pulmonary edema in pediatric acute respiratory distress syndrome received continuous hemofiltration therapy: a prospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Wang ◽  
Chunxia Wang ◽  
Jingyi Shi ◽  
Yijun Shan ◽  
Huijie Miao ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Oxygenation Index ◽  
Lung Compliance ◽  
Continuous Hemofiltration ◽  
Ultrasound Score

Abstract Background Lung ultrasound score is a potential method for determining pulmonary edema in acute respiratory distress syndrome (ARDS). Continuous renal replacement therapy (CRRT) has become the preferred modality to manage fluid overload during ARDS. The aim of this study was to evaluate the value of lung ultrasound (LUS) score on assessing the effects of CRRT on pulmonary edema and pulmonary function in pediatric ARDS. Methods We conducted a prospective cohort study in 70 children with moderate to severe ARDS in a tertiary university pediatric intensive care unit from January 2016 to December 2019. 37 patients received CRRT (CRRT group) and 33 patients treated by conventional therapy (Non-CRRT group). LUS score was measured within 2 h identified ARDS as the value of 1st, and the following three days as the 2nd, 3rd, and 4th. We used Spearman correlation analysis to develop the relationship between LUS score and parameters related to respiratory dynamics, clinical outcomes as well as daily fluid balance during the first four days after ARDS diagnosed. Results The 1st LUS score in CRRT group were significantly higher than Non-CRRT group (P < 0.001), but the LUS score decreased gradually following CRRT (P < 0.001). LUS score was significantly correlated with Cdyn (dynamic lung compliance) (1st: r = − 0.757, 2nd: r = − 0.906, 3rd: r = − 0.885, 4th: r = − 0.834), OI (oxygenation index) (1st: r = 0.678, 2nd: r = 0.689, 3rd: r = 0.486, 4th: r = 0.324) based on 1st to 4th values (all P < 0.05). Only values of the 3rd and 4th LUS score after ARDS diagnosed were correlated with duration of mechanical ventilation [1st: r = 0.167, P = 0.325; 2nd: r = 0.299, P = 0.072; 3rd: r = 0.579, P < 0.001; 4th: r = 0.483, P = 0.002]. LUS score decreased from 22 (18–25) to 15 (13–18) and OI decreased from 15.92 (14.07–17.73) to 9.49 (8.70–10.58) after CRRT for four days (both P < 0.001). Conclusions LUS score is significantly correlated with lung function parameters in pediatric ARDS. The improvement of pulmonary edema in patient with ARDS received CRRT can be assessed by the LUS score. Trial registration CCTR, ChiCTR-ONC-16009698. Registered 1 November 2016, prospectively registered, http://www.chictr.org.cn/edit.aspx?pid=16535&htm=4. This study adheres to CONSORT guidelines.

scholarly journals Lung ultrasound score assessing the pulmonary edema in pediatric acute respiratory distress syndrome received continuous hemofiltration therapy: A prospective observational study

2021 ◽  
Author(s):  
Fei Wang ◽  
Chunxia Wang ◽  
Jingyi Shi ◽  
Yijun Shan ◽  
Huijie Miao ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Pediatric Intensive Care ◽  
Potential Method ◽  
Continuous Hemofiltration ◽  
Ultrasound Score

Abstract Background: Lung ultrasound score is a potential method for determining pulmonary edema in acute respiratory distress syndrome (ARDS). Continuous renal replacement therapy (CRRT) has become the preferred modality to manage fluid overload during ARDS. The aim of this study was to evaluate the value of lung ultrasound (LUS) score on assessing the effects of CRRT on pulmonary edema and pulmonary function in pediatric ARDS. Methods: We conducted a prospective cohort study in 70 children with moderate to severe ARDS in a tertiary university pediatric intensive care unit from January 2016 to December 2019. 37 patients received CRRT (CRRT group) and 33 patients treated by conventional therapy (Non-CRRT group). LUS score was measured within 2 hours identified ARDS as the value of 1st，and the following three days as the 2nd, 3rd, and 4th. We used Spearman correlation analysis to develop the relationship between LUS score and parameters related to respiratory dynamics, clinical outcomes as well as daily fluid balance during the first four days after ARDS diagnosed.Results: The 1st LUS score in CRRT group were significantly higher than Non-CRRT group (P < 0.001), but the LUS score decreased gradually following CRRT (P < 0.001). LUS score was significantly correlated with Cdyn (1st: r =-0.757, 2nd: r =-0.906, 3rd: r =-0.885, 4th: r =-0.834), OI (1st: r =0.678, 2nd: r =0.689, 3rd: r =0.486, 4th: r =0.324) based on 1st to 4th values (all P <0.05). Only values of the 3rd and 4th LUS score after ARDS diagnosed were correlated with duration of mechanical ventilation [1st: r = 0.167, P = 0.325; 2nd: r = 0.299, P = 0.072; 3rd: r = 0.579, P < 0.001; 4th: r = 0.483, P = 0.002]. LUS score decreased from 22 (18 - 25) to 15 (13 - 18) and OI decreased from 15.92 (14.07 -17.73) to 9.49 (8.70 -10.58) after CRRT for four days (both P < 0.001).Conclusions: LUS score is significantly correlated with lung function parameters in pediatric ARDS. The improvement of pulmonary edema in patient with ARDS received CRRT can be assessed by the LUS score.Trial registration: CCTR, ChiCTR-ONC-16009698. Registered 1 November 2016, prospectively registered, http://www.chictr.org.cn/edit.aspx?pid=16535&htm=4. This study adheres to CONSORT guidelines.

Lung ultrasound and the role of lung aeration score in patients with acute respiratory distress syndrome on extracorporeal membrane oxygenation

2021 ◽  
pp. 039139882110513
Author(s):  
Stefanie Curry ◽  
Aileen Tan ◽  
Luna Gargani ◽  
Oriana Ng ◽  
Andrew Roscoe ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Pleural Effusions ◽  
Membrane Oxygenation ◽  
Lung Aeration ◽  
Vv Ecmo

Objective: This was a pilot study to determine the utility of daily lung ultrasound (LUS) in patients requiring veno-venous extracorporeal membrane oxygenation (VV-ECMO) for acute respiratory distress syndrome (ARDS). Design: This was a prospective, observational study. Setting: The study took place in the intensive care unit at Royal Papworth Hospital in Cambridge, UK. Participants: We recruited adult patients receiving VV-ECMO for ARDS. Interventions: All patients received a lung computed tomography (CT) scan and LUS on admission. Bedside chest radiography (CXR) and LUS were done on a daily basis until patients were decannulated. Measurements and main results: Daily LUS aeration scores were calculated according to the appearance of four defined patterns. An independent radiologist calculated corresponding scores for CT and CXR, retrospectively. These were checked for correlation with LUS aeration scores. There were statistically significant correlations between LUS versus CT ( r = 0.868, p = 0.002) and LUS versus CXR ( r = 0.498, p = 0.018) with good agreement and no evidence of proportional bias. LUS was able to detect 13.5% of pleural effusions and 54.2% of pneumothorax that were not picked up on CXR. In most of the patients who were weaned off VV-ECMO, a progressive reduction of LUS aeration scores corresponding to lung re-aeration was observed. Conclusions: LUS correlated with findings on CT and CXR for quantifying lung aeration and the clinical presentation of patients. LUS also picked up more pleural effusions and pneumothorax than CXR. Together with traditional imaging techniques, the routine use of LUS should be considered for this patient group.

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