Lung ultrasound score assessing the pulmonary edema in pediatric acute respiratory distress syndrome received continuous hemofiltration therapy: A prospective observational study
Background: Lung ultrasound score is a potential method for determining pulmonary edema in acute respiratory distress syndrome (ARDS). Continuous renal replacement therapy (CRRT) has become the preferred modality to manage fluid overload during ARDS. The aim of this study was to evaluate the value of lung ultrasound (LUS) score on assessing the effects of CRRT on pulmonary edema and pulmonary function in pediatric ARDS.
Methods: We conducted a prospective cohort study in 70 children with moderate to severe ARDS in a tertiary university pediatric intensive care unit from January 2016 to December 2019. 37 patients received CRRT (CRRT group) and 33 patients treated by conventional therapy (Non-CRRT group). LUS score was measured within 2 hours identified ARDS as the value of 1st,and the following three days as the 2nd, 3rd, and 4th. We used Spearman correlation analysis to develop the relationship between LUS score and parameters related to respiratory dynamics, clinical outcomes as well as daily fluid balance during the first four days after ARDS diagnosed.
Results: The 1st LUS score in CRRT group were significantly higher than Non-CRRT group (P < 0.001), but the LUS score decreased gradually following CRRT (P < 0.001). LUS score was significantly correlated with Cdyn (1st: r =-0.757, 2nd: r =-0.906, 3rd: r =-0.885, 4th: r =-0.834), OI (1st: r =0.678, 2nd: r =0.689, 3rd: r =0.486, 4th: r =0.324) based on 1st to 4th values (all P <0.05). Only values of the 3rd and 4th LUS score after ARDS diagnosed were correlated with duration of mechanical ventilation [1st: r = 0.167, P = 0.325; 2nd: r = 0.299, P = 0.072; 3rd: r = 0.579, P < 0.001; 4th: r = 0.483, P = 0.002]. LUS score decreased from 22 (18 - 25) to 15 (13 - 18) and OI decreased from 15.92 (14.07 -17.73) to 9.49 (8.70 -10.58) after CRRT for four days (both P < 0.001).
Conclusions: LUS score is significantly correlated with lung function parameters in pediatric ARDS. The improvement of pulmonary edema in patient with ARDS received CRRT can be assessed by the LUS score.
Trial registration: CCTR, ChiCTR-ONC-16009698. Registered 1 November 2016, prospectively registered, http://www.chictr.org.cn/edit.aspx?pid=16535&htm=4. This study adheres to CONSORT guidelines.
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Lung ultrasound score assessing the pulmonary edema in pediatric acute respiratory distress syndrome received continuous hemofiltration therapy: A prospective observational study
Posted 13 Jan, 2021
On 01 Jan, 2021
Posted 17 Dec, 2020
On 17 Dec, 2020
On 17 Dec, 2020
On 17 Dec, 2020
On 13 Dec, 2020
Received 08 Dec, 2020
Invitations sent on 30 Nov, 2020
On 30 Nov, 2020
On 29 Nov, 2020
On 29 Nov, 2020
On 29 Nov, 2020
On 12 Nov, 2020
Received 11 Nov, 2020
On 08 Nov, 2020
Invitations sent on 25 Oct, 2020
On 20 Sep, 2020
On 19 Sep, 2020
On 19 Sep, 2020
On 04 Sep, 2020
Received 16 Jul, 2020
Invitations sent on 06 Jul, 2020
On 06 Jul, 2020
On 30 Jun, 2020
On 29 Jun, 2020
On 29 Jun, 2020
Background: Lung ultrasound score is a potential method for determining pulmonary edema in acute respiratory distress syndrome (ARDS). Continuous renal replacement therapy (CRRT) has become the preferred modality to manage fluid overload during ARDS. The aim of this study was to evaluate the value of lung ultrasound (LUS) score on assessing the effects of CRRT on pulmonary edema and pulmonary function in pediatric ARDS.
Methods: We conducted a prospective cohort study in 70 children with moderate to severe ARDS in a tertiary university pediatric intensive care unit from January 2016 to December 2019. 37 patients received CRRT (CRRT group) and 33 patients treated by conventional therapy (Non-CRRT group). LUS score was measured within 2 hours identified ARDS as the value of 1st,and the following three days as the 2nd, 3rd, and 4th. We used Spearman correlation analysis to develop the relationship between LUS score and parameters related to respiratory dynamics, clinical outcomes as well as daily fluid balance during the first four days after ARDS diagnosed.
Results: The 1st LUS score in CRRT group were significantly higher than Non-CRRT group (P < 0.001), but the LUS score decreased gradually following CRRT (P < 0.001). LUS score was significantly correlated with Cdyn (1st: r =-0.757, 2nd: r =-0.906, 3rd: r =-0.885, 4th: r =-0.834), OI (1st: r =0.678, 2nd: r =0.689, 3rd: r =0.486, 4th: r =0.324) based on 1st to 4th values (all P <0.05). Only values of the 3rd and 4th LUS score after ARDS diagnosed were correlated with duration of mechanical ventilation [1st: r = 0.167, P = 0.325; 2nd: r = 0.299, P = 0.072; 3rd: r = 0.579, P < 0.001; 4th: r = 0.483, P = 0.002]. LUS score decreased from 22 (18 - 25) to 15 (13 - 18) and OI decreased from 15.92 (14.07 -17.73) to 9.49 (8.70 -10.58) after CRRT for four days (both P < 0.001).
Conclusions: LUS score is significantly correlated with lung function parameters in pediatric ARDS. The improvement of pulmonary edema in patient with ARDS received CRRT can be assessed by the LUS score.
Trial registration: CCTR, ChiCTR-ONC-16009698. Registered 1 November 2016, prospectively registered, http://www.chictr.org.cn/edit.aspx?pid=16535&htm=4. This study adheres to CONSORT guidelines.
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