Lung Ultrasound Score, Severity of Acute Lung Disease and Prolonged Mechanical Ventilation in Children.

Autor:	Oulego-Erroz I; Complejo Asistencial Universitario de Leon, Pediatric Intensive Care Medicine, Leon, Spain; ignacio.oulego@gmail.com., Del Pilar De Castro-Vecino M; Hospital Materno Infantil Gregorio Marañón, Pediatric Cardiology, Madrid, Comunidad de Madrid, Spain.; Universidad de Leon Instituto de Biomedicina, Leon, Castilla y León, Spain., González-Cortés R; Hospital Materno Infantil Gregorio Marañón, Pediatric Intensive Care Unit, Madrid, Comunidad de Madrid, Spain., Alonso-Ojembarrena A; Hospital Universitario Puerta del Mar, Neonatology, Cadiz, Spain., Rodríguez-Nuñez A; Complexo Hospitalario Universitario de Santiago de Compostela, Pediatric Critical, Intermediate and Palliative Care Section. , Santiago de Compostela, Galicia, Spain., Palanca-Arias D; Miguel Servet University Hospital, Pediatric Intensive Care Unit. , Zaragoza, Aragón, Spain.; University of Zaragoza Faculty of Medicine, Zaragoza, Aragón, Spain., Quesada-Ortega Ú; Hospital Universitario La Paz Hospital Materno Infantil, Pediatric Intensive Care Unit, Madrid, Comunidad de Madrid, Spain., Sanchiz-Cardenas S; Virgen de la Arrixaca University Hospital, Pediatric Intensive Care Unit, El Palmar, Murcia, Spain., Murillo-Pozo MÁ; Virgen del Rocio University Hospital, Pediatric Intensive Care Medicine, Sevilla, Andalucía, Spain., López-González J; Hospital Materno Infantil Gregorio Marañón, Pediatric Intensive Care Unit, Madrid, Comunidad de Madrid, Spain.; Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain., Sánchez-Yáñez P; Hospital Regional Universitario de Malaga, Pediatric Intensive Care Unit, Malaga, Andalucía, Spain.; Malaga Institute of Biomedical Research, Malaga, Andalucía, Spain., Valencia-Ramos J; Hospital Universitario de Burgos, Pediatri Intensive Care Unit, Burgos, Castilla y León, Spain.; University of Burgos, Burgos, Castilla y León, Spain., Fernández-de la Ballina A; Son Espases University Hospital, Pediatri Intensive Care Unit, Palma, Illes Balears, Spain., Chaves-Caro N; Hospital Universitario de Donostia, Pediatri Intensive Care Unit, San Sebastian, Spain., Borrego-Domínguez R; Hospital Universitario de Toledo, Pediatri Intensive Care Unit, Toledo, Spain., Sánchez-Porras M; Hospital Universitario Ramon y Cajal, Pediatri Intensive Care Unit, Madrid, Spain., Rodríguez-Martínez M; Hospital de la Santa Creu i Sant Pau, Pediatric Intensive Care Unit, Barcelona, Spain., Carballo-Martín PJ; Hospital Universitario Nuestra Señora de la Candelaria, Pediatri Intensive Care Unit, Santa Cruz de Tenerife, Canarias, Spain., Bermúdez-Barrezueta L; Hospital Clinico Universitario de Valladolid, Pediatric and Neonatal Intensive Care Unit, Valladolid, Castilla y León, Spain., Rodríguez-Fanjul J; University Hospital Germans Trias i Pujol, Neonatal Intensive Care Unit, Badalona, Catalunya, Spain., Vivanco-Allende A; Hospital Universitario Central de Asturias, Pediatric Intensive Care Unit, Oviedo, Asturias, Spain.; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain., Rodríguez-Campoy P; Hospital Universitario Puerta del Mar, Pediatric Intensive Care Unit, Cadiz, Andalucía, Spain., Vega-Puyal L; Hospital Universitari Dexeus, Pediatric Intensive Care Unit, Barcelona, Catalunya, Spain., Gil-Antón J; Cruces University Hospital, Pediatric Intensive Care Unit, Barakaldo, País Vasco, Spain., Sánchez-Martínez I; Complejo Hospitalario de Navarra, Pediatric Intensive Care Unit, Pamplona, Navarra, Spain., Pérez-Quevedo O; Hospital Universitario Materno Infantil de Canarias, Pediatric Intensive Care Unit, Las Palmas Gran Canaria, Spain., Muñoyerro-Sesmero M; Complejo Asistencial Universitario de Salamanca, Pediatric Intensive Care Unit, Salamanca, Castilla y Leon, Spain., Barón-González de Suso L; 12 de Octubre University Hospital, Pediatric Intensive Care Unit, Madrid, Comunidad de Madrid, Spain., Mayordomo-Colunga J; Hospital Universitario Central de Asturias, Pediatric Intensive Care Unit, Oviedo, Asturias, Spain.; Instituto de Investigacion Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain.; Centro de Investigación Biomédica en Red Enfermedades Respiratorias, Madrid, Comunidad de Madrid, Spain.
Jazyk:	angličtina
Zdroj:	American journal of respiratory and critical care medicine [Am J Respir Crit Care Med] 2024 Oct 17. Date of Electronic Publication: 2024 Oct 17.
DOI:	10.1164/rccm.202404-0843OC
Abstrakt:	Rationale: Lung ultrasound may be useful for prognostication of acute lung disease. Objectives: To assess whether the lung ultrasound score is associated with the severity of lung disease and may predict prolonged invasive mechanical ventilation in critically ill children. Methods: Prospective observational multicenter study in children aged 1 month to 18 years who required respiratory support in the intensive care unit. Children with chronic parenchymal lung disease were excluded. The lung ultrasound score was obtained at 12 hours and 48-72 hours from admission. Prolonged invasive mechanical ventilation was defined as >7 consecutive days. Correlation of the lung ultrasound score with oxygenation as well as its prognostic accuracy for prolonged invasive mechanical ventilation were investigated. Results: 538 children were included and 62 (11.5%) required prolonged mechanical ventilation. In these subjects, the lung ultrasound score was higher at 12 [24 (19-26) vs. 8 (3-14); p<0.001] and 48-72 hours [16 (10.5-22.5) vs. 6 (3-11) vs; p<0.001]. At 12 hours the lung ultrasound score correlated with oxygenation index [ R 2= 0.435 (95% CI: 0.293-0.566), rho coefficient -0.705, p<0.001] and oxygen saturation index [ R 2 0.499 (95% CI: 0.370-0.613), rho coefficient 0.651, p<0.001p<0.001]. To predict prolonged invasive mechanical ventilation, the lung ultrasound score at 12 hours had a good accuracy [AUROC=0.87 (95% CI: 0.81-0.93)] while its use in a multivariable model had an excellent accuracy both in derivation [AUROC=0.92 (95% CI: 0.89-0.95)] and internal validation [AUROC=0.91 (95% CI: 0.90-0.92)]. Conclusion: In critically ill children, the lung ultrasound score early after admission may predict prolonged invasive mechanical ventilation.
Databáze:	MEDLINE
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