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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Pulmonary Medicine 1/2015

Prognostic value of extravascular lung water assessed with lung ultrasound score by chest sonography in patients with acute respiratory distress syndrome

BMC Pulmonary Medicine > Ausgabe 1/2015
Zhen Zhao, Li Jiang, Xiuming Xi, Qi Jiang, Bo Zhu, Meiping Wang, Jin Xing, Dan Zhang
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

LJ and ZZ conceived and planned the program. XMX participated in the design of the study and performed the statistical analysis. ZZ drafted the manuscript and revised it critically for important intellectual content. BZ and QJ recorded the patients’ information. ZZ and MPW collected, analyzed, and interpreted the data. JX and DZ helped with lung ultrasound training. All authors read and approved the final manuscript.



The prognostic value of extravascular lung water indices (EVLWI) has been widely investigated, which is determined by lung ultrasound B-lines. However, the clinical value of lung ultrasound B-lines for determining prognosis/intensive care unit (ICU) outcomes in patients with acute respiratory distress syndrome (ARDS) has been rarely reported.


Twenty-one ARDS patients admitted to the ICU of Fu Xing Hospital underwent both lung ultrasonography and pulse index continuous cardiac output (PiCCO) monitoring on the first, second, and third days after diagnosis. The correlation between lung ultrasound score (LUS) and EVLWI measured by the PiCCO system was investigated. The prognostic clinical value of lung ultrasonography in ARDS patients was explored. Chest ultrasound was performed using the 12 regions method. The comprehensive score of lung ultrasound was determined according to the level of lung aeration.


With ICU mortality as the end point, 21 patients were divided into a survivor group (8 patients, 39.1 %) and a non-survivor group (13 patients, 61.9 %). Significant positive linear correlations were found between LUS and EVLWI, including predicted body weight (r2 = 0.906), sequential organ failure assessment score (r2 = 0.815), lung injury score (r2 = 0.361), and PaO2/FiO2 (r2 = 0.472). Significantly different LUSs were found between the non-survivor and survivor groups (F = 77.64, P <0.01) by repeated-measures analysis of variance. There were no significant differences between the two groups on different days. The areas under the receiver operating characteristic curves of LUS and EVLW measured by PiCCO were 0.846 (P < 0.01) and 0.918 (P < 0.01), respectively. The cut-off of LUS for prognosis prediction was 16.5.


Lung ultrasonography is a non-invasive, economic, simple, user-friendly, and radiation-free bedside method for predicting the prognosis of ARDS patients. Early measurement of LUS is a better prognostic indicator in patients with ARDS.
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