Open AccessLung ultrasound predicts acute respiratory distress syndrome in patients with paraquat intoxication
Author(s) -
Lu Xiao,
Wu DingQian,
Gao YuZhi,
Zhang Mao
Publication year - 2017
Publication title -
hong kong journal of emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 12
eISSN - 2309-5407
pISSN - 1024-9079
DOI - 10.1177/1024907917735087
Subject(s) - medicine , respiratory distress , lung , sepsis , respiratory system , mechanical ventilation , paraquat , intensive care unit , diffuse alveolar damage , respiratory failure , anesthesia , lung ultrasound , acute respiratory distress , biochemistry , chemistry
Objective: We assessed the evolution of lung aeration by “Lung Ultrasound Score” to predict the acute respiratory distress syndrome in patients with paraquat intoxication. Methods: Patients with paraquat intoxication treated in the intensive care unit were reviewed. Patients who had been assessed by transthoracic lung ultrasound at 3 time points as day 1, day 3, and day 7 after the treatment were analyzed. Lung aeration was represented by the lung ultrasound score. The relationship of the score with the development of acute respiratory distress syndrome was evaluated. Results: There were 50 patients included. On day 7, 18 patients developed the acute respiratory distress syndrome. The acute respiratory distress syndrome patients demonstrated a higher mortality rate than that for the non‐acute respiratory distress syndrome patients (88.9% vs 31.5%, p < 0.001). In addition, the acute respiratory distress syndrome patients not only had a higher creatinine level (p < 0.001), and Sepsis‐related Organ Failure Assessment 48‐h scores (p < 0.001), and a longer time to gastric lavage but also suffered from a lower PaO 2 /FiO 2 (p < 0.001) and a higher lung ultrasound score (p < 0.001) compared to those in the non‐acute respiratory distress syndrome patients. The decrease in PaO 2 /FiO 2 between day 3 and day 7 correlated with the increase in lung ultrasound score between day 3 and day 7. There was also a significant correlation between the Sepsis‐related Organ Failure Assessment score and lung ultrasound score in acute respiratory distress syndrome patient on day 7. Conclusion: The transthoracic lung ultrasound may be a useful tool for lung aeration assessment on patients with paraquat intoxication receiving treatment. Further studies are needed to evaluate the impact of this screening strategy on predicting acute respiratory distress syndrome.