Lung ultrasonography as a direct measure of evolving respiratory dysfunction and disease severity in patients with acute pancreatitis.

Autor: Skouras C; Clinical Surgery, The University of Edinburgh, Edinburgh, UK., Davis ZA; Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK., Sharkey J; Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK., Parks RW; Clinical Surgery, The University of Edinburgh, Edinburgh, UK., Garden JO; Clinical Surgery, The University of Edinburgh, Edinburgh, UK., Murchison JT; Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK., Mole DJ; Clinical Surgery, The University of Edinburgh, Edinburgh, UK.; MRC Centre for Inflammation Research, The University of Edinburgh, Edinburgh, UK.
Jazyk: angličtina
Zdroj: HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2015 Oct 16. Date of Electronic Publication: 2015 Oct 16.
DOI: 10.1111/hpb.12515
Abstrakt: Background: The value of lung ultrasonography in the diagnosis of respiratory dysfunction and severity stratification in patients with acute pancreatitis (AP) was investigated.
Methods: Over a 3-month period, 41 patients (median age: 59.1 years; 21 males) presenting with a diagnosis of potential AP were prospectively recruited. Each participant underwent lung ultrasonography, and the number of comet tails present on scans was linked with contemporaneous clinical data. Group comparisons, areas under the curve (AUC) and respective measures of diagnostic accuracy were investigated.
Results: A greater number of comet tails were evident in patients with respiratory dysfunction (P = 0.013), those with severe disease (P = 0.001) and when contemporaneous and maximum in-patient C-reactive protein (CRP) exceeded 150 mg/l (P = 0.018 and P = 0.049, respectively). Receiver-operator characteristic plot area under the curve (AUC) was greater when examining upper lung quadrants, using respiratory dysfunction and AP severity as variables of interest (AUC = 0.803, 95% CI: 0.583-1.000, and AUC = 0.996, 95% CI: 0.983-1.000, respectively). Examining all lung quadrants resulted in greater AUCs for contemporaneous and maximum CRP (AUC = 0.764, 95% CI: 0.555-0.972, and AUC = 0.704, 95% CI: 0.510-0.898).
Discussion: Ultrasonography of non-dependent lung parenchyma can reliably detect evolving respiratory dysfunction in AP. This simple bedside technique shows promise as an adjunct to severity stratification.
(© 2015 International Hepato-Pancreato-Biliary Association.)
Databáze: MEDLINE
Externí odkaz: