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The following is a summary of “Associations of early changes in lung ultrasound aeration scores and mortality in invasively ventilated patients: a post hoc analysis,” published in the July 2024 issue of Pulmonology by Sinnige et al.
Lung ultrasound (LUS) is increasingly recognized as a valuable tool in the intensive care unit (ICU), with the LUS aeration score demonstrating potential associations with mortality among invasively ventilated patients. This study aimed to evaluate the predictive value of both baseline and early changes in LUS aeration scores on 30-day and 90-day mortality in critically ill patients with and without Acute Respiratory Distress Syndrome (ARDS) undergoing invasive ventilation. The study is a post hoc analysis derived from a multicenter prospective observational cohort, focusing on patients admitted to the ICU expected to require ventilation for at least 24 hours. Inclusion criteria were narrowed to those who underwent a 12-region LUS exam at baseline and had available data on the primary endpoint of 30-day mortality.
Logistic regression assessed primary and secondary endpoints across the entire patient cohort and within predefined subgroups of patients with ARDS and non-ARDS. The study encompassed 442 patients, of whom 245 had a follow-up LUS exam. Results indicated that the baseline LUS aeration score did not significantly correlate with mortality (Odds Ratio: 1.02; 95% CI: 0.99 – 1.06; p = 0.143). This lack of association persisted across both ARDS and non-ARDS subgroups. However, a notable finding emerged among non-ARDS patients: early deterioration in the LUS aeration score was significantly linked to increased mortality (Odds Ratio: 2.09; 95% CI: 1.01 – 4.3; p = 0.046). This association was not observed in patients with ARDS or within the complete cohort. Consequently, while the baseline LUS aeration score may not be a reliable predictor of short-term mortality in critically ill ventilated patients, early changes in the LUS score appear to be a critical indicator of prognosis in non-ARDS patients.
This study underscores the nuanced role of LUS aeration scores in patient management. It highlights the need for further research to elucidate the mechanisms underlying these observations and to potentially refine LUS-based prognostic tools for better patient outcomes in the ICU.
Source: respiratory-research.biomedcentral.com/articles/10.1186/s12931-024-02893-0