Prognostic Value of the Radiographic Assessment of Lung Edema Score in Mechanically Ventilated ICU Patients
Issued Date
2023-02-01
Resource Type
eISSN
20770383
Scopus ID
2-s2.0-85148942551
Journal Title
Journal of Clinical Medicine
Volume
12
Issue
4
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Clinical Medicine Vol.12 No.4 (2023)
Suggested Citation
Filippini D.F.L., Hagens L.A., Heijnen N.F.L., Zimatore C., Atmowihardjo L.N., Schnabel R.M., Schultz M.J., Bergmans D.C.J.J., Bos L.D.J., Smit M.R. Prognostic Value of the Radiographic Assessment of Lung Edema Score in Mechanically Ventilated ICU Patients. Journal of Clinical Medicine Vol.12 No.4 (2023). doi:10.3390/jcm12041252 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82411
Title
Prognostic Value of the Radiographic Assessment of Lung Edema Score in Mechanically Ventilated ICU Patients
Other Contributor(s)
Abstract
Introduction: The Radiographic Assessment of Lung Edema (RALE) score provides a semi-quantitative measure of pulmonary edema. In patients with acute respiratory distress syndrome (ARDS), the RALE score is associated with mortality. In mechanically ventilated patients in the intensive care unit (ICU) with respiratory failure not due to ARDS, a variable degree of lung edema is observed as well. We aimed to evaluate the prognostic value of RALE in mechanically ventilated ICU patients. Methods: Secondary analysis of patients enrolled in the ‘Diagnosis of Acute Respiratory Distress Syndrome’ (DARTS) project with an available chest X-ray (CXR) at baseline. Where present, additional CXRs at day 1 were analysed. The primary endpoint was 30-day mortality. Outcomes were also stratified for ARDS subgroups (no ARDS, non-COVID-ARDS and COVID-ARDS). Results: 422 patients were included, of which 84 had an additional CXR the following day. Baseline RALE scores were not associated with 30-day mortality in the entire cohort (OR: 1.01, 95% CI: 0.98–1.03, p = 0.66), nor in subgroups of ARDS patients. Early changes in RALE score (baseline to day 1) were only associated with mortality in a subgroup of ARDS patients (OR: 1.21, 95% CI: 1.02–1.51, p = 0.04), after correcting for other known prognostic factors. Conclusions: The prognostic value of the RALE score cannot be extended to mechanically ventilated ICU patients in general. Only in ARDS patients, early changes in RALE score were associated with mortality.