Abstract
Methods A total of 121 patients with moderate to severe ARDS admitted to the intensive care unit (ICU) from June 2017 to April 2020 and treated with invasive mechanical ventilation were sequentially included in this study. Their general information was collected, and MP was recorded at 0 h, 24 h, 48 h, and 72 h after admission to the ICU. Professionally trained researchers performed the LUS assessments. Patients were divided into the death and survival groups according to their 28-day prognosis. The trend of MP and LUS at the four time points was analyzed. A receiver operating characteristic curve (ROC) was used to analyze the predictive value of MP and LUS scores at 0 h and 72 h for the prognosis (28-day mortality rate) of patients with moderate to severe ARDS. Results 121 patients were included in the analysis, of which 73 were male and 48 were female. When patients entered the ICU, their oxygenation index (t: 30885, P < 0.01), APACHE II score (t: 2.105, P < 0.05), and SOFA score (t: 4.134, P < 0.001) were higher in the death group than the survival group. The death group had significantly higher MP and LUS at each time point (0 h, 24 h, 48 h, and 72 h) compared to the survival group (all P < 0.05). There was a significant upward trend over time in the MP and LUS of the death group, contrasting to a significant downward trend in the survival group (all P < 0.05). The Pearson correlation analysis showed that MP and LUS were significantly positively correlated at each time point (r values: 0 h: 0.3027; 24 h: 0.3705; 48 h: 0.3902; 72 h: 0.5916; all P < 0.01). The ROC curves showed that MP and LUS at 72 h were of significant value in predicting the prognosis of ARDS patients, with areas under the curve of 0.866 ± 0.032 and 0.839 ± 0.037, respectively. Conclusion There was a significant correlation between the MP and LUS of ARDS patients at four time points from 0 to 72 h, which has a clinical value in evaluating severity and prognosis.
Highlights
Acute respiratory distress syndrome (ARDS) is one of the most common critical illnesses in intensive care medicine.An international epidemiological study (LUNG SAFE) reported that acute respiratory distress syndrome (ARDS) incidence in the intensive care unit (ICU) is about 10% [1]
Gattinoni et al [4] verified the accuracy of the Berlin standard of ARDS and found that parameters of respiratory mechanics during mechanical ventilation provide a meaningful tool for evaluating the severity and prognosis of ARDS
Through clinical and animal studies, the assessment of mechanical power has been confirmed as an effective means of evaluating the prognosis and severity of ARDS, especially the optimal MP values estimated by a dynamic treatment regime model are another better way than the gloss MP to show the association between MP and mortality outcome [5,6,7]
Summary
Acute respiratory distress syndrome (ARDS) is one of the most common critical illnesses in intensive care medicine.An international epidemiological study (LUNG SAFE) reported that ARDS incidence in the ICU is about 10% [1]. A total of 121 patients with moderate to severe ARDS admitted to the intensive care unit (ICU) from June 2017 to April 2020 and treated with invasive mechanical ventilation were sequentially included in this study. A receiver operating characteristic curve (ROC) was used to analyze the predictive value of MP and LUS scores at 0 h and 72 h for the prognosis (28-day mortality rate) of patients with moderate to severe ARDS. There was a significant correlation between the MP and LUS of ARDS patients at four time points from 0 to 72 h, which has a clinical value in evaluating severity and prognosis
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