Diagnostic Value of Pulmonary Ultrasound and Arterial Blood Gas Analysis in Acute Patients with Severe Injuries Complicated by Respiratory Failure-A Retrospective Study

Dongming Gu; Bo Zhang; Jing Li; Yanpeng Li; Zhihua Wang; Jianjun Diao

doi:10.2147/JMDH.S424667

Diagnostic Value of Pulmonary Ultrasound and Arterial Blood Gas Analysis in Acute Patients with Severe Injuries Complicated by Respiratory Failure-A Retrospective Study

J Multidiscip Healthc. 2023 Sep 13:16:2707-2714. doi: 10.2147/JMDH.S424667. eCollection 2023.

Authors

Dongming Gu¹, Bo Zhang¹, Jing Li¹, Yanpeng Li¹, Zhihua Wang¹, Jianjun Diao¹

Affiliation

¹ Department of Emergency, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 201399, People's Republic of China.

Abstract

Background: To investigate the early application of pulmonary ultrasonography and arterial blood gas analysis in critical patients with severe multiple injuries exacerbated by respiratory failure.

Patients and methods: The retrospective selection was performed on 81 patients admitted to our critical care unit between January 2020 and January 2021 with severe multiple injuries rendered worse by respiratory failure. Based on the different examination procedures, the patients were categorised into three groups (n=27): group A; diagnosed with pulmonary ultrasonography, group B; diagnosed with arterial blood gas; and group C; diagnosed with both pulmonary ultrasonography and arterial blood gas analyses. Patients were subsequently divided into a survival group (n = 65) and a death group (n = 16). On an annual basis, patients' prognoses were examined in relation to the predictive value of pulmonary ultrasound.

Results: Initial diagnosis, diagnosis, and initial correct treatment times were significantly shorter in groups B and C than group A (P<0.05). In contrast, initial diagnosis time, diagnosis time, and initial correct treatment times were potentially shorter in group C than in group B (P<0.05). Compared to groups B and C, group A had a considerably lower diagnosis rate for the examination methods (P<0.05). The right diaphragm displacement and left diaphragm displacement in the survival group were potentially higher than the LUS score (P < 0.05). In contrast, the survival group's lung ultrasound score (LUS) was considerably lower than the death group's. Statistical analysis showed that the predictive values of right diaphragm displacement, left diaphragm displacement, and mean diaphragm displacement were significant compared with the LUS score. The findings of the receiver operating characteristic curve demonstrated that the right, left, and average diaphragm displacements had high predictive values.

Conclusion: In the early evaluation of patients with severe multiple injuries complicated by respiratory failure, pulmonary ultrasonography combined with arterial blood gas analysis is crucial for the rapid diagnosis and prognosis prediction of patients.

Keywords: arterial blood gas analysis; pulmonary ultrasound; respiratory failure; severe multiple injuries.

Grants and funding

This work is supported by - The Research Grant for Health Science and Technology of the Pudong Municipal Commission of Health Committee of Shanghai (Grant No. PW2021A-70); the Project of Key Medical Specialty and Treatment Center of Pudong Hospital of Fudan University (Grant No. Zdzk2020-15); the Scientific Research Foundation provided by Pudong Hospital affiliated to Fudan University (Project no. YJRCJJ201910).