Bedside Ultrasound Assessment of Positive End-Expiratory Pressure-induced Lung Recruitment
Bedside Ultrasound Assessment of Positive End-Expiratory Pressure-induced Lung Recruitment
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DOI：
10.1164/rccm.201003-0369oc
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发表时间：
2011-02-01
影响因子：
24.7
通讯作者：
Rouby, Jean-Jacques
中科院分区：
文献类型：
--
作者：
Bouhemad, Belaid;Brisson, Helene;Rouby, Jean-Jacques
在危重患者中，肺超声（LUS）越来越多地被用于床边评估肺泡-间质综合征、肺实变、肺炎、气胸和胸腔积液。它可能是一种容易重复的无创评估肺再补充的工具。目的：我们的目的是比较压力容积（PV）曲线法与LUS法在评估急性呼吸窘迫综合征/急性肺损伤（ARDS/ALI）患者呼气末正压（PEEP）诱导的肺再募集中的作用。方法：对30例ARDS患者和10例ALI患者进行前瞻性研究。在PEEP 0和PEEP 15 cm H2O下测PV曲线和LUS。采用PV曲线法测定peep诱导的肺补充。测量和主要结果：定义了四个LUS实体：合并；多个，不规则间隔的B线；多个聚结的B系；正常通气。对检查的12个肺区域中的每一个，测量peep诱导的超声变化，并计算超声再通气评分。PV曲线测得peep诱导的肺再招募与超声再通气评分呈极显著相关(Rho = 0.88； P
Rationale In the critically ill patients, lung ultrasound (LUS) is increasingly being used at the bedside for assessing alveolar-interstitial syndrome, lung consolidation, pneumonia, pneumothorax, and pleural effusion. It could be an easily repeatable noninvasive tool for assessing lung recruitment.Objectives: Our goal was to compare the pressure volume (PV) curve method with LUS for assessing positive end-expiratory pressure (PEEP)-induced lung recruitment in patients with acute respiratory distress syndrome/acute lung injury (ARDS/ALI).Methods: Thirty patients with ARDS and 10 patients with ALI were prospectively studied. PV curves and LUS were performed in PEEP 0 and PEEP 15 cm H2O. PEEP-induced lung recruitment was measured using the PV curve method.Measurements and Main Results: Four LUS entities were defined: consolidation; multiple, irregularly spaced B lines; multiple coalescent B lines; and normal aeration. For each of the 12 lung regions examined, PEEP-induced ultrasound changes were measured, and an ultrasound reaeration score was calculated. A highly significant correlation was found between PEEP-induced lung recruitment measured by PV curves and ultrasound reaeration score (Rho = 0.88; P