title: Prognostic value of extravascular lung water assessed with lung ultrasound score by chest sonography in patients with acute respiratory distress syndrome.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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 (r (2) = 0.906), sequential organ failure assessment score (r (2) = 0.815), lung injury score (r (2) = 0.361), and PaO2/FiO2 (r (2) = 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.
  
  
  CONCLUSIONS
  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.
authors: Intensive Care Unit, Fuxing Hospital affiliated with Capital Medical University, Beijing, 100038, China. maggiezhao77@163.com.
authors: Zhen
authors: Z
authors: Zhao
authors: Intensive Care Unit, Fuxing Hospital affiliated with Capital Medical University, Beijing, 100038, China. jiangli@sina.com.
authors: Li
authors: L
authors: Jiang
authors: Intensive Care Unit, Fuxing Hospital affiliated with Capital Medical University, Beijing, 100038, China. xxm2973@sina.com.
authors: Xiuming
authors: X
authors: Xi
authors: Intensive Care Unit, Fuxing Hospital affiliated with Capital Medical University, Beijing, 100038, China. jiangqi7676@sinan.com.
authors: Qi
authors: Q
authors: Jiang
authors: Intensive Care Unit, Fuxing Hospital affiliated with Capital Medical University, Beijing, 100038, China. zhubo123123@sina.com.
authors: Bo
authors: B
authors: Zhu
authors: Intensive Care Unit, Fuxing Hospital affiliated with Capital Medical University, Beijing, 100038, China. xiaolajiao001326@126.com.
authors: Meiping
authors: M
authors: Wang
authors: Department of Ultrasonography, Fuxing Hospital affiliated with Capital Medical University, Beijing, 100038, China. xj8024@sina.com.
authors: Jin
authors: J
authors: Xing
authors: Department of Ultrasonography, Fuxing Hospital affiliated with Capital Medical University, Beijing, 100038, China. dan.zhang@263.net.
authors: Dan
authors: D
authors: Zhang
mesh_terms: D000368:Aged; D015633:Extravascular Lung Water / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D011379:Prognosis; D012372:ROC Curve; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography