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 [R2= 0.435 (95% CI: 0.293-0.566), rho coefficient -0.705, p<0.001] and oxygen saturation index [R2 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.

中文翻译：

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儿童肺部超声评分、急性肺病的严重程度和长时间机械通气。


基本原理 肺部超声可能有助于急性肺病的预后。目的 评估肺部超声评分是否与肺部疾病的严重程度相关，并可能预测危重症儿童延长有创机械通气。方法 对 1 个月至 18 岁在重症监护病房需要呼吸支持的儿童进行的前瞻性观察性多中心研究。患有慢性肺实质疾病的儿童被排除在外。入院后 12 小时和 48-72 小时获得肺部超声评分。延长有创机械通气定义为连续 >7 天。研究了肺部超声评分与氧合的相关性及其对延长有创机械通气的预后准确性。结果 纳入 538 例儿童，其中 62 例 （11.5%） 需要延长机械通气。在这些受试者中，肺部超声评分更高，为 12 [24 （19-26） vs. 8 （3-14）;p<0.001] 和 48-72 小时 [16 （10.5-22.5） vs. 6 （3-11） vs; p<0.001]。12 小时时，肺部超声评分与氧合指数 [R2= 0.435 （95% CI： 0.293-0.566）， rho 系数 -0.705， p<0.001] 和氧饱和度指数 [R2 0.499 （95% CI： 0.370-0.613）， rho 系数 0.651， p<0.001p<0.001] 相关。为了预测延长有创机械通气，12 小时肺部超声评分具有良好的准确性 [AUROC=0.87 （95% CI： 0.81-0.93）]，而其在多变量模型中的使用在推导 [AUROC=0.92 （95% CI： 0.89-0.95）] 和内部验证 [AUROC=0.91 （95% CI： 0.90-0.92）] 方面都具有出色的准确性。结论 在危重患儿中，入院后早期的肺部超声评分可能预示有创机械通气时间延长。