Value of bedside ultrasound in evaluating disease severity and prognosis of patients with severe pneumonia

XU Chengzhi; LIU Yun; YIN Fei

doi:10.7619/jcmp.20221711

Journal of Clinical Medicine in Practice > 2022 > 26(22): 38-42. > DOI: 10.7619/jcmp.20221711

XU Chengzhi, LIU Yun, YIN Fei. Value of bedside ultrasound in evaluating disease severity and prognosis of patients with severe pneumonia[J]. Journal of Clinical Medicine in Practice, 2022, 26(22): 38-42. DOI: 10.7619/jcmp.20221711

Citation:

PDF (961 KB)

Value of bedside ultrasound in evaluating disease severity and prognosis of patients with severe pneumonia

Department of Emergency Critical Care, Suzhou Ninth People's Hospital of Jiangsu Province, Suzhou, Jiangsu, 215000

More Information

Received Date: May 31, 2022
Available Online: December 01, 2022

Graphical Abstract

Abstract

Abstract

Objective
To explore the value of bedside ultrasound in evaluating the disease severity and prognosis of patients with severe pneumonia (SP).
Methods
The clinical data of 120 patients with SP admitted to the emergency intensive care unit (EICU) and intensive care unit (ICU) were retrospectively analyzed. All patients underwent bedside ultrasound after admission, and the pulmonary ultrasound score (LUS) was performed. Serum procalcitonin (PCT), C-reactive protein (CRP), arterial blood lactic acid(Lac) and oxygenation index of patients at admission were measured. The patients were divided into critical group and non-critical group according to the Acute Physiology and Chronic Health Status Scoring System Ⅱ (APACHEⅡ) score at admission, and were divided into good prognosis group and poor prognosis group according to prognosis at discharge. LUS and laboratory indexes were compared in each group. The value of LUS in evaluating the severity and prognosis of SP patients was analyzed.
Results
Among the 140 SP patients, 65 patients (54.17%) were not in critical condition at admission, 55 patients (45.83%) were in critical condition, 94 patients (78.33%) had good prognosis at discharge, and 26 patients (21.67%) had poor prognosis. The levels of LUS, PCT, CRP and Lac in the critical group were higher than those in the non-critical group, and the oxygenation index on admission was lower than that in the non-critical group (P < 0.05). The levels of LUS, PCT, CRP and Lac in the poor prognosis group were higher than those in the good prognosis group, and the value of oxygenation index was lower than that in the good prognosis group (P < 0.05). Pearson correlation analysis showed that LUS of SP patients was positively correlated with PCT, CRP and Lac(r=0.250, 0.412, 0.315, P < 0.05), was negatively correlated with oxygenation index (r=-0.235, P < 0.05). Receiver Operating Characteristic (ROC) curve showed that the area under the curve (AUC) of critical condition and poor prognosis of SP patients evaluated by LUS were 0.894 and 0.897 respectively, which had a certain value.
Conclusion
Bedside ultrasound has high value in evaluating the severity and prognosis of SP patients.
- severe pneumonia,
- bedside ultrasound,
- pulmonary ultrasound score

FullText(HTML)

References (19)

References

[1]	贾明雅, 郑喜胜, 董照刚, 等. 重症肺炎合并肺部感染患者胸部CT征象及其诊断价值研究[J]. 中国CT和MRI杂志, 2021, 19(5): 33-34. doi: 10.3969/j.issn.1672-5131.2021.05.011
[2]	赵浩天, 龙玲, 任珊, 等. 肺超声胸部X线和CPIS评分对ICU重症肺炎患者肺实变的诊断价值分析[J]. 河北医学, 2020, 26(12): 2056-2061. doi: 10.3969/j.issn.1006-6233.2020.12.029
[3]	BOUHEMAD B, DRANSART-RAYÉ O, MOJOLI F, et al. Lung ultrasound for diagnosis and monitoring of ventilator-associated pneumonia[J]. Ann Transl Med, 2018, 6(21): 418.
[4]	MONGODI S, VIA G, GIRARD M, et al. Lung ultrasound for early diagnosis of ventilator-associated pneumonia[J]. Chest, 2016, 149(4): 969-980. doi: 10.1016/j.chest.2015.12.012
[5]	何罗宜, 刘品晶, 黎李萍, 等. 床旁超声评估机械通气脓毒症患者血容量状态的临床研究[J]. 实用医学杂志, 2021, 37(6): 722-725. doi: 10.3969/j.issn.1006-5725.2021.06.006
[6]	张延峰, 梁文娇. 肺部超声与胸部X线片诊断成人社区获得性肺炎对比分析[J]. 贵州医药, 2019, 43(6): 970-971. doi: 10.3969/j.issn.1000-744X.2019.06.051
[7]	邢然然, 戴勇, 黄怀. 床旁超声在重症患者肺康复中的应用进展[J]. 中国康复理论与实践, 2021, 27(2): 187-190. https://www.cnki.com.cn/Article/CJFDTOTAL-ZKLS202102011.htm
[8]	中国医师协会急诊医师分会. 中国急诊重症肺炎临床实践专家共识[J]. 中国急救医学, 2016, 36(2): 97-107. doi: 10.3969/j.issn.1002-1949.2016.02.001
[9]	ARBELOT C, FERRARI F, BOUHEMAD B, et al. Lung ultrasound in acute respiratory distress syndrome and acute lung injury[J]. Curr Opin Crit Care, 2008, 14(1): 70-74. doi: 10.1097/MCC.0b013e3282f43d05
[10]	KNAUS W A, ZIMMERMAN J E, WAGNER D P, et al. APACHE-acute physiology and chronic health evaluation: a physiologically based classification system[J]. Crit Care Med, 1981, 9(8): 591-597. doi: 10.1097/00003246-198108000-00008
[11]	BARTOŠ H, DŽUPOVÁ O. Severe community-acquired pneumonia in intensive care[J]. Epidemiol Mikrobiol Imunol, 2020, 69(4): 159-163.
[12]	俞春梅, 朱保锋, 彭强, 等. 经鼻高流量氧疗在重症肺炎合并急性呼吸窘迫综合征患者中的应用研究[J]. 实用临床医药杂志, 2021, 25(18): 20-23, 28. doi: 10.7619/jcmp.20210515
[13]	STAUB L J, MAZZALI BISCARO R R, KASZUBOWSKI E, et al. Lung ultrasound for the emergency diagnosis of pneumonia, acute heart failure, and exacerbations of chronic obstructive pulmonary disease/asthma in adults: a systematic review and meta-analysis[J]. J Emerg Med, 2019, 56(1): 53-69. doi: 10.1016/j.jemermed.2018.09.009
[14]	UNLUKAPLAN I M, DOGAN H, OZUCELIK D N. Lung ultrasound for the diagnosis of pneumonia in adults[J]. J Pak Med Assoc, 2020, 70(6): 989-992.
[15]	SEZGIN C, GUNALP M, GENC S, et al. Diagnostic value of bedside lung ultrasonography in pneumonia[J]. Ultrasound Med Biol, 2020, 46(5): 1189-1196. doi: 10.1016/j.ultrasmedbio.2020.01.014
[16]	连细华, 吕国荣, 朱志兴, 等. 肺部超声B线征与肺水肿病理的相关性研究[J]. 中国超声医学杂志, 2020, 36(2): 181-184. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY202002024.htm
[17]	CARBONELL R, MORENO G, MARTÍN-LOECHES I, et al. Prognostic value of procalcitonin and C-reactive protein in 1608 critically ill patients with severe influenza pneumonia[J]. Antibiotics: Basel, 2021, 10(4): 350. doi: 10.3390/antibiotics10040350
[18]	廖艳洁, 尤丽, 胡振春. 动脉血乳酸、氧合指数、D-二聚体对老年重症肺炎患者并发急性呼吸窘迫综合征的预测价值[J]. 空军医学杂志, 2021(5): 410-412. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJZY202105013.htm
[19]	刘莹, 邓西龙, 潘越峻, 等. 肺部超声评估重症肺炎严重程度及预后的价值[J]. 实用医学杂志, 2018, 34(12): 2074-2078. doi: 10.3969/j.issn.1006-5725.2018.12.038

Cited By

Cited by

Periodical cited type(8)

1.	陈红涛，曲军，胡润武. 减压植骨内固定术与颈椎前路交锁钢板治疗颈椎骨折的有效性和安全性对比. 社区医学杂志. 2024(04): 112-116 .
2.	梁波. 血清ODF、IGF-1水平与股骨干骨折带锁髓内钉内固定术后骨不连相关因素分析. 河南外科学杂志. 2024(02): 92-94 .
3.	肖有伸，陈睿娜，杨玉菊，郑钰，谷雪莲，李海. 基于有限元仿真的髓内钉参数对儿童股骨干骨折的影响. 北京生物医学工程. 2024(03): 221-228 .
4.	李冰. 拉力螺钉联合交锁髓内钉内固定术治疗AO-C型股骨干骨折患者的效果. 中国民康医学. 2023(09): 63-66 .
5.	朱宏，周立国. 交锁髓内钉与钢板内固定对股骨骨折患者围术期指标及并发症的影响. 系统医学. 2023(16): 56-59 .
6.	徐志，仲鹤鹤，向浩，李恩超，黄榆顺，陆浩，金瑛，邹刚，刘毅. 股骨干骨折3种不同固定方式的有限元分析. 中国组织工程研究. 2022(33): 5271-5277 .
7.	罗忠开. 儿童及青少年股骨干骨折的治疗现状研究. 中国实用医药. 2021(13): 200-202 .
8.	钟天生，杨亚东，钟伟建. 自主体位联合交锁髓内钉内固定术治疗股骨骨折患儿的效果. 中国民康医学. 2021(23): 77-79 .

Other cited types(1)

Get Citation

PDF

XML

Article views (234) PDF downloads (12) Cited by(9)

Turn off MathJax

Article Contents

Abstract

References

Value of bedside ultrasound in evaluating disease severity and prognosis of patients with severe pneumonia

Abstract

References

Cited by

Periodical cited type(8)

Other cited types(1)

Catalog

Export File

Citation

Format

Content