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Abstract：
BACKGROUND: Lung ultrasound (LUS) in an emerging technique used in the intensive care unit (ICU). The derivative LUS aeration score has been shown to have associations with mortality in invasively ventilated patients. This study assessed the predictive value of baseline and early changes in LUS aeration scores in critically ill invasively ventilated patients with and without ARDS (Acute Respiratory Distress Syndrome) on 30- and 90-day mortality.
METHODS: This is a post hoc analysis of a multicenter prospective observational cohort study, which included patients admitted to the ICU with an expected duration of ventilation for at least 24 h. We restricted participation to patients who underwent a 12-region LUS exam at baseline and had the primary endpoint (30-day mortality) available. Logistic regression was used to analyze the primary and secondary endpoints. The analysis was performed for the complete patient cohort and for predefined subgroups (ARDS and no ARDS).
RESULTS: A total of 442 patients were included, of whom 245 had a second LUS exam. The baseline LUS aeration score was not associated with mortality (1.02 (95% CI: 0.99 - 1.06), p = 0.143). This finding was not different in patients with and in patients without ARDS. Early deterioration of the LUS score was associated with mortality (2.09 (95% CI: 1.01 - 4.3), p = 0.046) in patients without ARDS, but not in patients with ARDS or in the complete patient cohort.
CONCLUSIONS: In this cohort of critically ill invasively ventilated patients, the baseline LUS aeration score was not associated with 30- and 90-day mortality. An early change in the LUS aeration score was associated with mortality, but only in patients without ARDS.
BACKGROUND: ClinicalTrials.gov, ID NCT04482621.
METHODS: This is a post hoc analysis of a multicenter prospective observational cohort study, which included patients admitted to the ICU with an expected duration of ventilation for at least 24 h. We restricted participation to patients who underwent a 12-region LUS exam at baseline and had the primary endpoint (30-day mortality) available. Logistic regression was used to analyze the primary and secondary endpoints. The analysis was performed for the complete patient cohort and for predefined subgroups (ARDS and no ARDS).
RESULTS: A total of 442 patients were included, of whom 245 had a second LUS exam. The baseline LUS aeration score was not associated with mortality (1.02 (95% CI: 0.99 - 1.06), p = 0.143). This finding was not different in patients with and in patients without ARDS. Early deterioration of the LUS score was associated with mortality (2.09 (95% CI: 1.01 - 4.3), p = 0.046) in patients without ARDS, but not in patients with ARDS or in the complete patient cohort.
CONCLUSIONS: In this cohort of critically ill invasively ventilated patients, the baseline LUS aeration score was not associated with 30- and 90-day mortality. An early change in the LUS aeration score was associated with mortality, but only in patients without ARDS.
BACKGROUND: ClinicalTrials.gov, ID NCT04482621.
摘要：
背景：重症监护病房（ICU）中使用的新兴技术中的肺超声（LUS）。已证明衍生的LUS通气评分与有创通气患者的死亡率有关。这项研究评估了有或没有ARDS（急性呼吸窘迫综合征）的危重患者的LUS通气评分的基线和早期变化对30天和90天死亡率的预测价值。
方法：这是一项多中心前瞻性观察队列研究的事后分析，其中包括入住ICU且预期通气时间至少24小时的患者。我们限制参与基线时接受12个区域LUS检查且具有主要终点(30日死亡率)的患者.采用Logistic回归分析主要终点和次要终点。对完整患者队列和预定亚组（ARDS和无ARDS）进行分析。
结果：共纳入442例患者，其中245人参加了第二次LUS考试。基线LUS通气评分与死亡率无关(1.02(95%CI:0.99-1.06),p=0.143）。这一发现在ARDS患者和无ARDS患者中没有什么不同。LUS评分的早期恶化与死亡率相关(2.09(95%CI:1.01-4.3),p=0.046）在无ARDS的患者中，但不是在ARDS患者或完整的患者队列中。
结论：在这个危重病侵入性通气患者队列中，基线LUS通气评分与30日和90日死亡率无关.LUS通气评分的早期变化与死亡率相关，但仅限于无ARDS的患者。
背景：ClinicalTrials.gov，IDNCT04482621。
方法：这是一项多中心前瞻性观察队列研究的事后分析，其中包括入住ICU且预期通气时间至少24小时的患者。我们限制参与基线时接受12个区域LUS检查且具有主要终点(30日死亡率)的患者.采用Logistic回归分析主要终点和次要终点。对完整患者队列和预定亚组（ARDS和无ARDS）进行分析。
结果：共纳入442例患者，其中245人参加了第二次LUS考试。基线LUS通气评分与死亡率无关(1.02(95%CI:0.99-1.06),p=0.143）。这一发现在ARDS患者和无ARDS患者中没有什么不同。LUS评分的早期恶化与死亡率相关(2.09(95%CI:1.01-4.3),p=0.046）在无ARDS的患者中，但不是在ARDS患者或完整的患者队列中。
结论：在这个危重病侵入性通气患者队列中，基线LUS通气评分与30日和90日死亡率无关.LUS通气评分的早期变化与死亡率相关，但仅限于无ARDS的患者。
背景：ClinicalTrials.gov，IDNCT04482621。
