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116075

Value of Ultrasound in the Management of Acute Respiratory Distress Syndrome by Optimal PEEP

Article

Last updated: 04 Jan 2025

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Subjects

-

Tags

Internal Medicine

Abstract

Background: Acute respiratory distress syndrome [ARDS] is usually associated with significant morbidities and may need admission to the intensive care unit [ICU]. Mechanical ventilation, when indicated, needs continuous monitoring.
Aim of the work: To assess the clinical value of ultrasonic monitoring in pulmonary recruitment and optimal positive end-expiratory pressure [PEEP] in ARD cases.
Methods: It included thirty patients with ARDS. All were subjected to clinical evaluation, X-ray chest, lung ultrasound, and laboratory investigations. All patients underwent mechanical ventilation by increasing PEEP, starting at 5 mmHg then [6, 9, 12, and 15 mmHg] according to patient response with documentation of good response. At each PEEP, a chest ultrasound was completed, and results were correlated with respiratory functions.
Results: Hypertension, diabetes, COPD and hypothyroidism were reported in 63.3%, 66.7%, 16.7% and 40.0% respectively. The rate of primary weaning success was 36.7%, and 30.0% achieved weaning success in the third trail; tracheostomy indicated for 13.3%, pneumothorax 10.0%, pleural effusion 6.7%, and the mortality rate was 33.3%. Increased PEEP was concomitant by the progressive improvement of respiratory functions. In addition, there was a progressive significant decrease of B-lines at different areas from right and left lungs. All effects were significant at PEEP 9.
Conclusions: Gradual increments of PEEP helps to tailor the patient response on an individual basis. The use of readily available, portable ultrasound permits the daily monitoring and could guide the treatment protocol

DOI

10.21608/ijma.2020.116075

Keywords

acute respiratory distress syndrome, Mechanical Ventilation, lung ultrasound, positive end expiratory pressure, B-lines

Authors

First Name

Ali Mohamed Ali

Last Name

Abdelhameed

MiddleName

-

Affiliation

Department of Chest Diseases, Damietta Faculty of Medicine, Al-Azhar University, Egypt

Email

alifouda2017@gmail.com

City

Cairo

Orcid

-

First Name

Atef Wahdan Saleh

Last Name

Alrifai

MiddleName

-

Affiliation

Department of Chest Diseases, Damietta Faculty of Medicine, Al-Azhar University, Egypt

Email

atefchest@gmail.com

City

Mansoura

Orcid

-

First Name

Abdelhay Ibraheem

Last Name

Abdelhay

MiddleName

-

Affiliation

Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Egypt

Email

dr.abdoibrahim11@domazhermedicine.edu.eg

City

Cairo

Orcid

-

Volume

3

Article Issue

1

Related Issue

21557

Issue Date

2021-01-01

Receive Date

2020-08-25

Publish Date

2021-01-01

Page Start

1,104

Page End

1,112

Print ISSN

2636-4174

Online ISSN

2682-3780

Article File

IJMA_Volume 3_Issue 1_Pages 1104-1112.pdf

PDF . 1.6MB

Link

https://ijma.journals.ekb.eg/article_116075.html

Detail API

https://ijma.journals.ekb.eg/service?article_code=116075

Order

28

Type

Original Article

Type Code

816

Publication Type

Journal

Publication Title

International Journal of Medical Arts

Publication Link

https://ijma.journals.ekb.eg/

MainTitle

Value of Ultrasound in the Management of Acute Respiratory Distress Syndrome by Optimal PEEP

Details

Type

Article

Created At

22 Jan 2023