Clinical Application Value of Emergency and Bedside Pulmonary Ultrasound in Patients with Acute Respiratory Distress Syndrome

HOU Xiaohui; ZHANG Mingqin

doi:10.13919/j.issn.2095-6274.ZHJY202412015

Abstract：Objective To assess the clinical value and significance of emergency and bedside pulmonary ultrasound in patients with acute respiratory distress syndrome(ARDS).Methods A retrospective analysis was conducted on the clinical data of 90 patients suspected of having ARDS who presented at the Fourth Affiliated Hos-pital of Nanjing Medical University between January 2019 and July 2024.All patients underwent chest computed tomography(CT)and pulmonary ultrasound examinations.The results of chest CT and pulmonary ultrasound were analyzed,focusing on the assessment value of pulmonary ultrasound in determining the success of weaning from mechanical ventilation in ARDS patients.Results Among the 90 patients suspected of having ARDS,70 exhib-ited varying degrees of positive findings on chest CT,including interlobular septal thickening,ground-glass opac-ities,pulmonary consolidations,bronchial vascular signs,and pleural effusions.Additionally,63 patients showed positive ultrasound findings to varying degrees.Using chest CT as the diagnostic"gold standard"for ARDS,the sensitivity of pulmonary ultrasound in diagnosing ARDS was found to be 92.86%,with a specificity of 65%and an accuracy of 86.67%.The Kappa value for consistency testing was 0.601.Among the 70 ARDS patients,62 were successfully weaned from mechanical ventilation,rep-resenting 88.57%,while 8 patients were not success-fully weaned,accounting for 11.2%.There were no significant differences between the two groups concern-ing gender,age,duration of mechanical ventilation,inhaled oxygen concentration,oxygenation index,heart rate,or mean arterial pressure(P>0.05).Compared to the unsuccessful weaning group,the successful weaning group had significantly lower pulmonary ultrasound scores(P<0.001)and higher maximal expiratory and inspiratory diaphrag-matic thicknesses(P<0.001).Spearman correlation analysis indicated a correlation between pulmonary ultrasound scores,maximal diaphragmatic thickness at expiration and inspiration,and the success of weaning.Conclusion Pulmonary ultrasound,as a non-invasive,convenient,and highly sensitive imaging technique,holds significant val-ue in the screening and diagnosis of acute respiratory distress syndrome.Pulmonary ultrasound scoring can serve as an important auxiliary tool for clinicians in assessing the timing of weaning from mechanical ventilation.