Abstract
Usefulness of lung ultrasound in assessment of aeration before and after Recruitment maneuver in ARDS patients
Highlights
One of the common causes of respiratory failure in critical care unites is The Acute Respiratory Distress Syndrome (ARDS) [1], with Mechanical ventilation is still the backbone of its management [2].Low tidal volumes and limited airway pressure were recommended by the ARDS network trial to avoid overdistension, along with high or moderate positive end-expiratory pressure (PEEP) to prevent alveolar collapse; these were found to improve survival in patients with ARDS [3] Recruitment maneuvers (RM) which is a transient dynamic rise in transpulmonary pressure [4], have been used as an adjunct to mechanical ventilation in ARDS
Patients and Methods: 2.1Type, site and time of study: An observational study held on 40 Patients fulfilling the criteria of ARDS according to Berlin definition [14], admitted to critical care department; Beni-Suef University hospital from October 2017 to March 2019 were included in the study
In a study of 50 patients with paraquat intoxication for the prediction of ARDS growth, Xiao Lu et al found that patients with ARDS have a lower PaO2/FiO2 (p 0.001) and a higher lung ultrasound score (p 0.001) than non-ARDS patients, and that the decrease in PaO2/FiO2 was associated with the increase in Lung ultrasound score (LUS) between days 3 and 7 [24]
Summary
One of the common causes of respiratory failure in critical care unites is The Acute Respiratory Distress Syndrome (ARDS) [1], with Mechanical ventilation is still the backbone of its management [2].Low tidal volumes and limited airway pressure were recommended by the ARDS network trial to avoid overdistension, along with high or moderate positive end-expiratory pressure (PEEP) to prevent alveolar collapse; these were found to improve survival in patients with ARDS [3] Recruitment maneuvers (RM) which is a transient dynamic rise in transpulmonary pressure [4], have been used as an adjunct to mechanical ventilation in ARDS. Chest radiography was the first radiographic modality for diagnosing lung consolidation, but it has limitations as compared to other imaging modalities such as computed tomography in terms of accuracy and sensitivity in detecting pulmonary infiltrates [6,7]. Lung ultrasound may be a good alternative to chest radiography for ARDS diagnosis. Compared to ordinary chest radiography, it had a high sensitivity and accuracy in detecting lung consolidation of pneumonia [9, 10]. Lung ultrasound has been shown to be useful in detecting pathological features like lung edoema, consolidation, and pleural effusion [11,12]. It is low-cost and compact, making it ideal for use in resourceconstrained environments [8]. In ARDS patients,to direct the recruitment manoeuvre. [13]
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