The Validity of Quantifying Pulmonary Contusion Extent by Lung Ultrasound Score for Predicting ARDS in Blunt Thoracic Trauma
Background. Thoracic trauma comprises 20–25% of all traumas worldwide and constitutes the third most common cause of death after abdominal injury and head trauma in polytrauma patients. Pulmonary contusion (PC) is a common injury seen after blunt trauma that is associated with significant morbidity...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-01-01
|
| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2022/3124966 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832563510674980864 |
|---|---|
| author | Mohamed Soliman Sayed Kareem Abdelhamid Elmeslmany Ahmed Samir Elsawy Nashwa Abed Mohamed |
| author_facet | Mohamed Soliman Sayed Kareem Abdelhamid Elmeslmany Ahmed Samir Elsawy Nashwa Abed Mohamed |
| author_sort | Mohamed Soliman Sayed |
| collection | DOAJ |
| description | Background. Thoracic trauma comprises 20–25% of all traumas worldwide and constitutes the third most common cause of death after abdominal injury and head trauma in polytrauma patients. Pulmonary contusion (PC) is a common injury seen after blunt trauma that is associated with significant morbidity and mortality. The aim of this prospective study was to determine the value of PC extent measurements using lung ultrasound in predicting high risk patients for ARDS development. Methods. In one year, 50 polytrauma patients with blunt chest trauma were admitted to the ICU at Damanhur Institute. Lung contusion extent was evaluated using a lung US score (LUS) and was compared to the CT contusion score. The ability of the LUS to predict ARDS was tested. The diagnostic accuracy of LUS was compared with chest radiography for lung contusion and pneumothorax with thoracic CT scan as a reference. Patients were restratified by LUS into two groups: severe and nonsevere contusion group. The two groups' data were compared with respect to difference in mortality and injury characteristics. Results. Lung contusion assessed by LUS score was well correlated to thoracic CT scan measurements (r = 0.78). A LUS of 4 was defined as a cut-off value for predicting ARDS development within 72 hours of trauma with sensitivity and specificity (91.67% and 84.21%), respectively. Patients with severe lung contusions had a lower hypoxic index on admission, more ventilator days, a higher risk of ARDS development, more fractured ribs; higher rate of hemothorax and a higher ISS score than patients with nonsevere lung contusions. Conclusion. LUS on admission can quantify lung contusion extent and the high risk of developing ARDS after blunt thoracic trauma. |
| format | Article |
| id | doaj-art-9e9446abaf1948d09d832c4d186f81cd |
| institution | Kabale University |
| issn | 2090-1313 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-9e9446abaf1948d09d832c4d186f81cd2025-02-03T01:20:00ZengWileyCritical Care Research and Practice2090-13132022-01-01202210.1155/2022/3124966The Validity of Quantifying Pulmonary Contusion Extent by Lung Ultrasound Score for Predicting ARDS in Blunt Thoracic TraumaMohamed Soliman Sayed0Kareem Abdelhamid Elmeslmany1Ahmed Samir Elsawy2Nashwa Abed Mohamed3Critical Care Medicine DepartmentDamanhour Medical Institute Intensive Care UnitCritical Care Medicine DepartmentCritical Care Medicine DepartmentBackground. Thoracic trauma comprises 20–25% of all traumas worldwide and constitutes the third most common cause of death after abdominal injury and head trauma in polytrauma patients. Pulmonary contusion (PC) is a common injury seen after blunt trauma that is associated with significant morbidity and mortality. The aim of this prospective study was to determine the value of PC extent measurements using lung ultrasound in predicting high risk patients for ARDS development. Methods. In one year, 50 polytrauma patients with blunt chest trauma were admitted to the ICU at Damanhur Institute. Lung contusion extent was evaluated using a lung US score (LUS) and was compared to the CT contusion score. The ability of the LUS to predict ARDS was tested. The diagnostic accuracy of LUS was compared with chest radiography for lung contusion and pneumothorax with thoracic CT scan as a reference. Patients were restratified by LUS into two groups: severe and nonsevere contusion group. The two groups' data were compared with respect to difference in mortality and injury characteristics. Results. Lung contusion assessed by LUS score was well correlated to thoracic CT scan measurements (r = 0.78). A LUS of 4 was defined as a cut-off value for predicting ARDS development within 72 hours of trauma with sensitivity and specificity (91.67% and 84.21%), respectively. Patients with severe lung contusions had a lower hypoxic index on admission, more ventilator days, a higher risk of ARDS development, more fractured ribs; higher rate of hemothorax and a higher ISS score than patients with nonsevere lung contusions. Conclusion. LUS on admission can quantify lung contusion extent and the high risk of developing ARDS after blunt thoracic trauma.http://dx.doi.org/10.1155/2022/3124966 |
| spellingShingle | Mohamed Soliman Sayed Kareem Abdelhamid Elmeslmany Ahmed Samir Elsawy Nashwa Abed Mohamed The Validity of Quantifying Pulmonary Contusion Extent by Lung Ultrasound Score for Predicting ARDS in Blunt Thoracic Trauma Critical Care Research and Practice |
| title | The Validity of Quantifying Pulmonary Contusion Extent by Lung Ultrasound Score for Predicting ARDS in Blunt Thoracic Trauma |
| title_full | The Validity of Quantifying Pulmonary Contusion Extent by Lung Ultrasound Score for Predicting ARDS in Blunt Thoracic Trauma |
| title_fullStr | The Validity of Quantifying Pulmonary Contusion Extent by Lung Ultrasound Score for Predicting ARDS in Blunt Thoracic Trauma |
| title_full_unstemmed | The Validity of Quantifying Pulmonary Contusion Extent by Lung Ultrasound Score for Predicting ARDS in Blunt Thoracic Trauma |
| title_short | The Validity of Quantifying Pulmonary Contusion Extent by Lung Ultrasound Score for Predicting ARDS in Blunt Thoracic Trauma |
| title_sort | validity of quantifying pulmonary contusion extent by lung ultrasound score for predicting ards in blunt thoracic trauma |
| url | http://dx.doi.org/10.1155/2022/3124966 |
| work_keys_str_mv | AT mohamedsolimansayed thevalidityofquantifyingpulmonarycontusionextentbylungultrasoundscoreforpredictingardsinbluntthoracictrauma AT kareemabdelhamidelmeslmany thevalidityofquantifyingpulmonarycontusionextentbylungultrasoundscoreforpredictingardsinbluntthoracictrauma AT ahmedsamirelsawy thevalidityofquantifyingpulmonarycontusionextentbylungultrasoundscoreforpredictingardsinbluntthoracictrauma AT nashwaabedmohamed thevalidityofquantifyingpulmonarycontusionextentbylungultrasoundscoreforpredictingardsinbluntthoracictrauma AT mohamedsolimansayed validityofquantifyingpulmonarycontusionextentbylungultrasoundscoreforpredictingardsinbluntthoracictrauma AT kareemabdelhamidelmeslmany validityofquantifyingpulmonarycontusionextentbylungultrasoundscoreforpredictingardsinbluntthoracictrauma AT ahmedsamirelsawy validityofquantifyingpulmonarycontusionextentbylungultrasoundscoreforpredictingardsinbluntthoracictrauma AT nashwaabedmohamed validityofquantifyingpulmonarycontusionextentbylungultrasoundscoreforpredictingardsinbluntthoracictrauma |