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

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.