title: [Assessment of positive end-expiratory pressure induced lung volume change by ultrasound in mechanically ventilated patients].
abstract: OBJECTIVE
  To investigate the value of lung ultrasound for assessing positive end-expiratory pressure (PEEP) -induced lung volume change in mechanically ventilated patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) .
  
  
  METHODS
  Eighteen patients with ALI or ARDS were prospectively studied. P-V curves and lung ultrasound were performed at PEEP 12, 8, 4 and 0 cm H2O (1 cm H2O = 0.098 kPa). PEEP-induced lung volume change was measured using the P-V curve method and lung ultrasound.
  
  
  RESULTS
  Four lung ultrasound entities were defined: consolidation, multiple irregularly spaced B lines, multiple abutting B lines and normal aeration.For each of the 12 lung regions examined, PEEP-induced ultrasound changes were measured and an lung ultrasound score (LUS) was calculated. A highly significant correlation was found between PEEP-induced lung volume change measured by P-V curves and LUS change (r = 0.82, P < 0.01) . A statistically significant correlation was found between LUS change and PEEP-induced increase in PaO2 (r = 0.66, P < 0.01).
  
  
  CONCLUSIONS
  PEEP-induced lung volume change can be adequately estimated with bedside lung ultrasound. Since lung ultrasound cannot assess PEEP-induced lung hyperinflation, it should not be the sole method for PEEP titration.
authors.affiliation: Intensive Care Unit, the First Hospital of Jiaxing, Jiaxing 314001, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Shen
authors.forename: Rubin
authors.initials: R
authors.lastname: Luo
authors.forename: Yuzhi
authors.initials: Y
authors.lastname: Gao
authors.forename: Jiwen
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine; Research Institute of Emergency Medicine Zhejiang University, Hangzhou 310009, China. Email:zmhz@hotmail.com.
authors.forename: Mao
authors.initials: M
authors.lastname: Zhang
mesh_terms: D055371:Acute Lung Injury / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011175:Positive-Pressure Respiration / Q000379:methods*; D011446:Prospective Studies; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D014463:Ultrasonography; D014797:Vital Capacity