The correlation between lung ultrasound score and severity of postoperative patients of general surgery in ICU / 中国医师进修杂志

ABSTRACT

Objective To evaluate the value of lung ultrasound score (LUS) on assessing the severity and extubation opportunity in postoperative patients of general surgery, and to investigate the correlation between LUS and oxygenation index (PaO2/FiO2), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA), stay length in ICU and stay length in hospital. Methods A prospective double- blind cohort study was conducted. Eighty- nine postoperative patients of general surgery with successful extubation were selected, and the patients were divided into 2 groupsgroup A ( admission ICU to extubation time less than 48 h, 52 cases) and group B(admission ICU to extubation time more than 48 h, 37 cases). Before extubation, the PaO2/FiO2 was recorded according the blood gas analysis, and APACHE Ⅱ, SOFA and LUS were examined, and the staying time in ICU and staying time in hospital were recorded. The correlation was analyzed. Results The LUS, APACHE Ⅱ, SOFA, staying time in ICU and staying time in hospital in group A were significantly lower than those in group B (3.98 ± 2.31) scores vs. (13.41 ± 2.82) scores, (7.52 ± 1.96) scores vs. (14.92 ± 3.07) scores, (4.50 ± 2.24) scores vs. (9.70 ± 3.64) scores, (1.77 ± 1.41) d vs. (8.49 ± 4.35) d and (8.49 ± 2.28) d vs. (15.63 ± 6.10) d, and the PaO2/FiO2 was significantly higher than that in group B(441.57 ± 45.31) mmHg (1 mmHg=0.133 kPa) vs. (305.78 ± 90.72) mmHg, and there were statistical differences (P<0.01). The LUS had negative correlation with the PaO2/FiO2 (r=-0.882, P<0.01), and it had positive correlation with APACHEⅡ, SOFA, staying time in ICU and staying time in hospital (r=0.711, 0.590, 0.930 and 0.709;P<0.01). Conclusions The LUS is simple and easily available. It can evaluate the changes of pulmonary ventilation, and also evaluate its degree of severity and prognosis. It is helpful in the prediction of the extubation time, staying time in ICU and staying time in hospital in patients with general surgery.