Seibel, Armin ORCID: 0000-0003-1617-7225, Zechner, Peter M., Berghold, Andrea, Holter, Magdalena, Brass, Patrick, Michels, Guido, Leister, Nicolas ORCID: 0000-0003-1932-0701, Gemes, Geza, Donauer, Reinmar, Giebler, Reiner M. and Sakka, Samir G. (2020). B-Lines for the assessment of extravascular lung water: Just focused or semi-quantitative? Acta Anaesthesiol. Scand., 64 (7). S. 953 - 961. HOBOKEN: WILEY. ISSN 1399-6576

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Abstract

Background B-lines as typical artefacts of lung ultrasound are considered as surrogate measurement for extravascular lung water. However, B-lines develop in the sub-pleural space and do not allow assessment of the whole lung. Here, we present data from the first observational multi-centre study focusing on the correlation between a B-lines score and extravascular lung water in critically ill patients suffering from a variety of diseases. Patients and Methods In 184 adult patients, 443 measurements were obtained. B-lines were counted and expressed in a score which was compared to extravascular lung water, measured by single-indicator transpulmonary thermodilution. Appropriate correlation coefficients were calculated and receiver operating characteristics (ROC-) curves were plotted. Results Overall, B-lines score was correlated with body weight-indexed extravascular lung water characterized by r = .59. The subgroup analysis revealed a correlation coefficient in patients without an infection of r = .44, in those with a pulmonary infection of r = .75 and in those with an abdominal infection of r = .23, respectively. Using ROC-analysis the sensitivity and specificity of B-lines for detecting an increased extravascular lung water (>10 mL/kg) was 63% and 79%, respectively. In patients with a P/F ratio <200 mm Hg, sensitivity and specificity to predict an increased extravascular lung water was 71% and 93%, respectively. Conclusions Assessment of B-lines does not accurately reflect actual extravascular lung water. In presence of an impaired oxygenation, B-lines may reliably indicate increased extravascular lung water as cause of the oxygenation disorders.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Seibel, ArminUNSPECIFIEDorcid.org/0000-0003-1617-7225UNSPECIFIED
Zechner, Peter M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berghold, AndreaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holter, MagdalenaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brass, PatrickUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Michels, GuidoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Leister, NicolasUNSPECIFIEDorcid.org/0000-0003-1932-0701UNSPECIFIED
Gemes, GezaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Donauer, ReinmarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giebler, Reiner M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sakka, Samir G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-337202
DOI: 10.1111/aas.13586
Journal or Publication Title: Acta Anaesthesiol. Scand.
Volume: 64
Number: 7
Page Range: S. 953 - 961
Date: 2020
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1399-6576
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
RESPIRATORY-DISTRESS-SYNDROME; VASCULAR-PERMEABILITY INDEX; PULMONARY-EDEMA; ULTRASOUND; ACCURACY; COMETSMultiple languages
AnesthesiologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/33720

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