The ratio of right ventricle to left ventricular end diastolic area measured by echocardiog-raphy combined with pulmonary ultrasound score to predict the prognosis of patients with ARDS
Objective To investigate the value of combining conventional echocardiography measurements of the ra-tio of right ventricular end-diastolic area to left ventricular end-diastolic area(RVEDA/LVEDA)and lung ultrasound(LUS)scoring in predicting the clinical prognosis of adult patients with severe acute respiratory distress syndrome(ARDS).Method This retrospective study included 118 adult patients with ARDS admitted to Jinhua People's Hospital,Zhejiang Province,from March 2021 to June 2023.Patients were divided into a survival group(n=79)and a mortality group(n=39)based on 28-day mortality.Comparisons were made between the two groups regarding the Acute Physiology and Chronic Health Evaluation II(APACHE II)score upon admission,right ventricular end-diastolic and end-systolic areas(RVEDA and RVESA),left ven-tricular end-diastolic and end-systolic areas(LVEDA and LVESA),left ventricular ejection fraction(LVEF),and plasma brain natriuretic peptide(BNP)levels.LUS was used to assess the number of B-lines,lung consolidation,and bronchial air trapping,and to calculate the right ventricular fractional area change(RVFAC),RVEDA/LVEDA,and LUS semi-quantitative score.Result Univariate analysis showed that the RVFAC,RVEDA/LVEDA,and BNP levels were higher in the mortality group,while the number of B-lines,lung consolidation,and bronchial air trapping were significantly increased,and the LUS semi-quantitative score was higher(P<0.01).Spearman correlation analysis showed that RVEDA/LVEDA was positively cor-related with RVFAC,BNP levels,the number of B-lines,and the LUS semi-quantitative score,and the LUS semi-quantita-tive score was positively correlated with BNP levels(P<0.01).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)for predicting short-term mortality in adult patients with severe ARDS was 0.786 for RVEDA/LVEDA and 0.823 for the LUS semi-quantitative score(P<0.01),and the combined AUC was 0.897,which was signif-icantly higher than that of a single index(P<0.01).Conclusion Conventional echocardiography measurement of RVEDA/LVEDA and LUS semi-quantitative scoring can be used as important objective indicators for early prediction of short-term mortality in adult patients with severe ARDS.
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