■肺超声(LUS)是一种评估过度水合的简单床边工具。我们的研究旨在评估血管外肺水(EVLW)使用B线,并将其与断奶,机械通气的持续时间,重症监护病房(ICU)收治的危重患者的死亡率。
■150名机械通气ICU患者前瞻性观察超过18个月,记录了他们的人口统计学和临床数据。从第1天至第5天,第7天,第10天以及此后每周一次,在四个肋间空间(ICS)中使用LUS监测血管外肺水。肺液体负荷分级为低(1-10),中等(11-20),高(21-32)。断奶结果,断奶时间,机械通气,ICU停留,比较有和没有EVLW的患者的死亡率。
■在150名患者中,有54名患者(36.0%)患有EVLW。我们患者的平均肺评分为8.57±6.0。EVLW的平均检测时间为1.43±2.24天。40例(26.67%)患者肺评分较低,9例(6.00%)患者中度,5例(3.33%)患者高。断奶失败发生率(p值=0.006),断奶时间,机械通气,ICU住院时间(每个p值<0.0001),EVLW患者的总死亡率明显较高(p值=0.006).
■我们得出的结论是,相当比例的危重患者患有EVLW。血管外肺水显著增加断奶时间,机械通气天数,ICU停留,和危重患者的总死亡率。
■RajpalM,塔尔瓦五世,克里希纳B,MustafiSM.使用肺部超声评估重症监护病房重症患者的血管外肺水。印度J暴击护理中心2024;28(2):165-169。
UNASSIGNED: Lung ultrasound (LUS) is a simple bedside tool to assess overhydration. Our study aimed to assess extravascular lung water (EVLW) using B-lines and correlate it with weaning, duration of mechanical ventilation, and mortality in critically ill patients admitted to the intensive care unit (ICU).
UNASSIGNED: 150 mechanically ventilated ICU patients prospectively observed over 18 months, with their demographic and clinical data noted. Extravascular lung water was monitored using LUS in four intercostal spaces (ICS) from day 1 to day 5, day 7, day 10, and weekly thereafter. Pulmonary fluid burden was graded as low (1-10), moderate (11-20), and high (21-32). Weaning outcome, duration of weaning, mechanical ventilation, ICU stay, and mortality were compared in patients with and without EVLW.
UNASSIGNED: Out of 150, 54 patients (36.0%) had EVLW. The mean lung score amongst our patients was 8.57 ± 6.0. The mean time for detection of EVLW was 1.43 ± 2.24 days. Lung score was low in 40 (26.67%) patients, moderate in 9 (6.00%) patients, and high in 5 (3.33%) patients. Incidence of weaning failure (p-value = 0.006), duration of weaning, mechanical ventilation, ICU stay (p-value < 0.0001 each), and overall mortality were significantly higher in patients with EVLW (p-value = 0.006).
UNASSIGNED: We conclude that a good proportion of critically ill patients have EVLW. Extravascular lung water significantly increases the duration of weaning, mechanical ventilation days, ICU stay, and overall mortality in critically ill patients.
UNASSIGNED: Rajpal M, Talwar V, Krishna B, Mustafi SM. Assessment of Extravascular Lung Water Using Lung Ultrasound in Critically Ill Patients Admitted to Intensive Care Unit. Indian J Crit Care Med 2024;28(2):165-169.