Lung Ultrasound Score as a Predictor of Clinical Severity and Prognosis in Patients of Ventilator-associated Pneumonia

Abstract

Background: To estimate a correlation between change in lung ultrasound aeration score (LUSS) and mortality in patients with ventilator-associated pneumonia. Materials and methods: We conducted a prospective observational study in which lung ultrasound, the partial pressure of arterial oxygen to fraction of inspired oxygen ratio (PaO2/FiO2 ratio), and static lung compliance were performed for five consecutive days since the diagnosis of ventilator-associated pneumonia (day 1–5) in a 20-bed multidisciplinary intensive care unit in at a tertiary care academic institute in Northern India. A hundred and seventeen ventilated patients were studied for the first 5 days after ventilator-associated pneumonia (VAP) development. Lung ultrasounds were performed with an ultrasonography machine using a round-tipped probe of 2–5 MHz at six different areas of each hemithorax, which includes superior and inferior in anterior, lateral, and posterior lung fields. Patients with a decreased LUSS of 2 were labeled as responders. A decrease of LUSS of less than 2 or an increase of LUSS were leveled as nonresponders. Results: The correlation between the change in LUSS between days 1 and 5 was significant with 28-day mortality (26.3% in responders vs 87.8% nonresponses with p < 0.001) Conclusion: The responders to treatment for VAP described by LUSS had lower mortality than non-responders.