B-lines score on lung ultrasound as a direct measure of respiratory dysfunction in ICU patients with acute kidney injury

Abstract

LUS can be used for functional lung evaluation and identification of patients with increase pulmonary water content and decrease PaO/FiO ratio.

Using lung ultrasound to quantitatively evaluate pulmonary water content

“…Our results suggest that the BLS is highly correlated with the PaO 2 /FiO 2 ratio, which is consistent with previous data revealing that the LUS score was significantly correlated with the oxygenation index in critical care patients . These findings are also consistent with those reported by Bilotta et al and Ciumanghel et al indicating that the BLS was strongly correlated with the PaO 2 /FiO 2 ratio in neurocritical care patients ( r = −.8) and in patients with acute kidney injury. Cagini et al found that LUS could detect EVLW increases after major pulmonary resection and a significant inverse correlation was also observed between the B‐line score and the PaO 2 /FiO 2 respiratory ratios.…”

The Role of Point-of-Care Ultrasound Monitoring in Cardiac Surgical Patients With Acute Kidney Injury

“…In patients with AKI, the B-line score was correlated negatively with the partial pressure of oxygen in relation to the inspired oxygen concentration (PaO 2 /FiO 2 ratio). 130 Improving the evaluation of organ congestion using POCUS may lead to a pre-emptive initiation of RRT in patients with severe AKI before an acute complication develops, such as acute pulmonary edema requiring emergency endotracheal intubation. Furthermore, repeated assessment of these markers may be useful to guide fluid removal with diuretics or with ultrafiltration after the initiation of RRT.…”

Prognostic value of lung ultrasonography after on-pump cardiac surgery

“…Имеющиеся в литературе данные о наличии взаимосвязи между послеоперационной оксигенацией и ультразвуковой оценкой интерстициального синдрома и консолидации весьма противоречивы [6,20]. Так, у пациентов после обширных абдоминальных вмешательств подобной взаимосвязи установлено не было [6].…”

“…В этой же работе была показана удовлетворительная предиктивная способность ультразвуковой оценки степени консолидации легочной ткани в отношении отсроченной гипоксемии. Вместе с тем у пациентов с отеком легких на фоне развития острого повреждения почек взаимосвязь между количеством B-линий и гипоксемией прослеживалась весьма отчетливо [20]. Возможность ультразвука оценивать количество В-линий использовалась рядом авторов как маркер начинающейся гипергидратации и рекомендована для протоколов целенаправленной инфузионной терапии [21].…”

“…The ROC analysis showed that increased numbers of B-lines above 10 at 6 hours after completion of the surgery was predictive of the development of X-ray abnormalities at 24 hours (AUC 0.82, р = 0.02, sensitivity 86%, specificity 76%). At 6 hours after the intervention the patients who subsequently required prolonged mechanical ventilation had increased numbers of B-lines (15 [14][15][16][17][18][19][20][21][22][23][24][25][26][27]) compared to those who could be extubated within the first 24 hours after surgery (10 [3-13], p = 0.02).…”