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| Value analysis on the evaluation of severity and prognosis in patients with acute respiratory distress syndrome by severe ultrasound |
| LIU Xing1 LI Xiaolei2 HUANG Zhongyi2 LI Jianqiu2 |
1.Department of Emergency, Shenzhen Longhua District Central Hospital, Guangdong Province, Shenzhen 518110, China;
2.Department of Emergency, Shenzhen Hospital Southern Medical University, Guangdong Province, Shenzhen 518101, China |
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Abstract Objective To analyze the value of severe ultrasound in the evaluation of severity and prognosis of patients with acute respiratory distress syndrome. Methods The clinical data of 50 (critical ultrasound score and care group) patients with acute respiratory distress syndrome (ARDS) who were monitored by ICU in Shenzhen Hospital Southern Medical University (hereinafter referred to as “our hospital”) from January 2017 to January 2019 were analyzed retrospectively. According to the prognosis, the patients were divided into death group (15 cases) and survival group (35 cases). According to the severity of the disease (oxygenation index ＞200-300 mmHg is mild, oxygenation index ＞200-300 mmHg is moderate, and oxygenation index≤100 mmHg is severe), they were divided into light group (13 cases), medium group (15 cases) and heavy group (22 cases). The correlation between severe ultrasonic score and acute physiology and chronic health status scoring system (APACHE Ⅱ), sequential organ failure score, and oxygenation index was observed. Another 50 patients with acute respiratory distress syndrome admitted to our hospital during the same period were selected (routine care group), the hospital stay, mechanical ventilation time, ICU time, fatality rate and failure of ventilator evacuation were compared under different monitoring methods. Results The final positive pressure of ventilator parameters was compared between the death group and the survival group, and the difference was statistically significant (P ＜ 0.05), the critical ultrasound score of patients in the death group was significantly higher than that in the survival group (P ＜ 0.05), severe set of APACHE Ⅱ, sequential organ failure score and severe ultrasonic score were higher than mild and moderate groups (P ＜ 0.05). The severe ultrasonic score was positively correlated with APACHE Ⅱ, sequential organ failure score positive correlation (r = 0.641, P ＜ 0.01; r = 0.523, P ＜ 0.01), while negatively correlated with oxygenation index (r = -0.715, P ＜ 0.01). Compared with the conventional monitoring group, the hospital stay was shorter, the ventilation time was shorter, the ICU time was shorter, and the fatality rate, withdrawal failure rate of ventilator vacuation and disability rate of critical ultrasound score care group were lower, the differences were statistically significant (P ＜ 0.05). Conclusion The use of severe ultrasound score in the clinical condition monitoring of patients with acute respiratory distress syndrome can effectively evaluate the severity of the patients′ condition, which has high application value.
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