Prophetic values of lung ultrasound score on post-extubation distress in patients with acute respiratory distress syndrome

Abstract

Abstract Background Acute respiratory distress syndrome (ARDS) has been a prevalent disease in ICU with mortality of up to 27–45%. A considerable proportion of extubated ARDS patients passing spontaneous breathing trial (SBT) still requires reintubation. Methods Lung ultrasonography (LUS) was used to predict the success rate of extubation. Ninety-two patients passing the 60-min SBT were included in this prospective research. Their clinical characters including LUS, APACHE II, SOFA, CPIS, EVLWI and PaO2/FiO2 were collected before the SBT. Another two LUS assessments were performed at the end of and 4 h after SBT. LUS results were evaluated and scored by two independent experts, and the correlations of LUS scores, APACHE-II scores, SOFA scores, CPIS and EVLWI with the success rate of extubation and rate of reintubation were analyzed. Results Failed weaning and reintubation of ARDS patients were correlated with higher LUS scores both before and after SBT. Post-extubation distress was correlated with higher APACHE-II scores, SOFA scores, CPIS and EVLWI before SBT. There were positive correlations between the LUS score and APACHE-II score, SOFA score, CPIS and EVLWI before SBT, respectively. Conclusion LUS score measured at the end of 60-min SBT could be used to predict post-extubation distress in ARDS patients.

Keywords

• Lung ultrasonography (LUS)
• Acute respiratory distress syndrome (ARDS)
• Spontaneous breathing trial (SBT)
• Post-extubation distress