Lung Ultrasound to Determine the Effect of Lower vs. Higher PEEP on Lung Aeration in Patients without ARDS—A Substudy of a Randomized Clinical Trial
Issued Date
2023-06-01
Resource Type
eISSN
20754418
Scopus ID
2-s2.0-85164128392
Journal Title
Diagnostics
Volume
13
Issue
12
Rights Holder(s)
SCOPUS
Bibliographic Citation
Diagnostics Vol.13 No.12 (2023)
Suggested Citation
Zimatore C., Algera A.G., Botta M., Pierrakos C., Serpa Neto A., Grasso S., Schultz M.J., Pisani L., Paulus F. Lung Ultrasound to Determine the Effect of Lower vs. Higher PEEP on Lung Aeration in Patients without ARDS—A Substudy of a Randomized Clinical Trial. Diagnostics Vol.13 No.12 (2023). doi:10.3390/diagnostics13121989 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/87950
Title
Lung Ultrasound to Determine the Effect of Lower vs. Higher PEEP on Lung Aeration in Patients without ARDS—A Substudy of a Randomized Clinical Trial
Author's Affiliation
Mahidol Oxford Tropical Medicine Research Unit
Hogeschool van Amsterdam, University of Applied Sciences
Ospedale General Regionale F. Miulli
Università degli studi di Bari Aldo Moro
Hospital Israelita Albert Einstein
Faculty of Medicine, Nursing and Health Sciences
Nuffield Department of Medicine
Amsterdam UMC - University of Amsterdam
Hogeschool van Amsterdam, University of Applied Sciences
Ospedale General Regionale F. Miulli
Università degli studi di Bari Aldo Moro
Hospital Israelita Albert Einstein
Faculty of Medicine, Nursing and Health Sciences
Nuffield Department of Medicine
Amsterdam UMC - University of Amsterdam
Other Contributor(s)
Abstract
Background: Ventilation with lower positive end–expiratory pressure (PEEP) may cause loss of lung aeration in critically ill invasively ventilated patients. This study investigated whether a systematic lung ultrasound (LUS) scoring system can detect such changes in lung aeration in a study comparing lower versus higher PEEP in invasively ventilated patients without acute respiratory distress syndrome (ARDS). Methods: Single center substudy of a national, multicenter, randomized clinical trial comparing lower versus higher PEEP ventilation strategy. Fifty–seven patients underwent a systematic 12–region LUS examination within 12 h and between 24 to 48 h after start of invasive ventilation, according to randomization. The primary endpoint was a change in the global LUS aeration score, where a higher value indicates a greater impairment in lung aeration. Results: Thirty–three and twenty–four patients received ventilation with lower PEEP (median PEEP 1 (0–5) cm H2O) or higher PEEP (median PEEP 8 (8–8) cm H2O), respectively. Median global LUS aeration scores within 12 h and between 24 and 48 h were 8 (4 to 14) and 9 (4 to 12) (difference 1 (–2 to 3)) in the lower PEEP group, and 7 (2–11) and 6 (1–12) (difference 0 (–2 to 3)) in the higher PEEP group. Neither differences in changes over time nor differences in absolute scores reached statistical significance. Conclusions: In this substudy of a randomized clinical trial comparing lower PEEP versus higher PEEP in patients without ARDS, LUS was unable to detect changes in lung aeration.