Background
Methods
Subjects
Study protocol
Lung ultrasound
Lung computed tomography
Statistics
Results
Study population
Variables | Overall (N = 47) | Training set (N = 25) | Validation set (N = 22) |
---|---|---|---|
Age (years) | 52 (44–63) | 57 (50–65) | 48 (41–58) |
PBW (kg) | 64 (57–71) | 65 (57–71) | 64 (58–70) |
Gender (M/F) | 31/16 | 17/8 | 14/8 |
Risk factors for ARDS—N (%) | |||
Pneumonia | 42 (89) | 24 (85) | 21 (96) |
Non-pulmonary sepsis | 2 (4) | 2 (7) | 0 (0) |
Pancreatitis | 3 (6) | 2 (7) | 1 (4) |
SAPS II score | 36 (29–45) | 34 (27–44) | 39 (29–47) |
SOFA score | 8 (7–11) | 8 (7–11) | 9 (7–11) |
TV/PBW (mL/kg) | 6.6 (5.9–7.8) | 6.9 (6.0–7.9) | 6.4 (5.8–7.5) |
PEEPtot (cmH2O) | 14 (11–15) | 13 (10–15) | 14 (12–16) |
Pplat (cmH2O) | 25 (23–27) | 25 (23–27) | 25 (20–26) |
FiO2 | 0.6 (0.5–0.8) | 0.6 (0.5–0.8) | 0.5 (0.45–0.7) |
Blood gas exchange | |||
pH | 7.41 (7.35–7.46) | 7.41 (7.35–7.45) | 7.39 (7.35–7.46) |
PaO2/FiO2 | 166 (109–232) | 156 (108–233) | 178 (114–240) |
PaCO2 | 48 (41–52) | 48 (41–52) | 48 (42–50) |
Lactate | 1.7 (1.3–2.2) | 1.7 (1.3–2.6) | 1.6 (1.2–1.8) |
MAP (mmHg) | 83 (75–89) | 82 (73–88) | 84 (77–94) |
HR (bpm) | 89 (77–98) | 91 (81–98) | 86 (77–100) |
Total and regional LUS score in different ARDS morphologies
Variables | Overall (N = 47) | Training set (N = 25) | Validation set (N = 22) | |||
---|---|---|---|---|---|---|
Focal (N = 11) | Non-focal (N = 36) | Focal (N = 5) | Non-focal (N = 20) | Focal (N = 6) | Non-focal (N = 16) | |
LUSTOT | 14 (10–20) | 24 (18–27)* | 14 (8–19) | 24 (19–27)* | 16 (12–20) | 22 (17–27) ** |
LUSV | 1 (0–2) | 6 (4–8)* | 1 (0–1) | 6 (5–8)* | 2 (1–3) | 6 (4–7)* |
LUSI | 4 (2–7) | 8 (5–9)*,o | 3 (1–7) | 9 (6–9)**,oo | 4 (3–9) | 8 (4–10) |
LUSD | 10 (6–12)o,@@ | 9 (8–11)o,@@ | 12 (6–12)oo | 9 (8–11)o | 10 (7–11)o | 10 (7–12) o |
Amount of normally, poorly and not aerated lung tissue at different LUS scores
Accuracy of LUS in identifying ARDS morphology
LUSV | Sensitivity (%) | Specificity (%) | Correctly classified (%) | LR+ | LR− |
---|---|---|---|---|---|
≥ 0 | 100.00 | 0.00 | 80.00 | 1.0000 | |
≥ 1 | 95.00 | 40.00 | 84.00 | 1.5833 | 0.1250 |
≥ 3 | 95.00 | 100.00 | 96.00 | 0.0500 | |
≥ 4 | 85.00 | 100.00 | 88.00 | 0.1500 | |
≥ 6 | 75.00 | 100.00 | 80.00 | 0.2500 | |
≥ 7 | 40.00 | 100.00 | 52.00 | 0.6000 | |
≥ 8 | 35.00 | 100.00 | 48.00 | 0.6500 | |
≥ 9 | 15.00 | 100.00 | 32.00 | 0.8500 | |
> 9 | 0.00 | 100.00 | 20.00 | 1.0000 | |
Observations (n) | 25, training set | ||||
ROC area (SE; 95% CI) | 0.9600 (0.0405; 0.88069–1.0000) |