关键词: 呼吸窘迫综合征, 超声检查, 血管外肺水, 心功能

Abstract:

Objective To explore the imaging characteristics and diagnostic points of patients with acute respiratory distress syndrome (ARDS) underwent cardiopulmonary ultrasound as the initial diagnosis. Methods Nine patients with an initial diagnosis of ARDS in our hospital from November 2018 to March 2022 through bedside ultrasound were selected. The imaging features and summarize diagnostic points were analyzed, as well as clinical manifestations, laboratory tests, prognosis, and other clinical characteristics. Results Among the nine cases of ARDS, left cardiogenic dyspnea was excluded by echocardiography in eight cases, and one case showed imaging findings of an increase in left ventricular filling pressure and pulmonary capillary wedge pressure, but excluded for cardiogenic pulmonary edema by lung ultrasound. There were four cases of right ventricular enlargement, three cases of decreased right ventricular systolic function, and seven cases of increased pulmonary artery pressure. Five cases of inferior vena cava dilation and eight cases of reduced inferior vena cava variability were detected. Compared with the Berlin Definition of ARDS, ultrasonic diagnosis of ARDS was significantly shorter (14.22±3.77 min vs 65.78±17.90 min, P<0.05). Conclusion Ultrasound is helpful as an imaging tool for early diagnosis and evaluation of ARDS, as well as for evaluating lung exudation, volume load, cardiac function, and circulatory status, providing reference for clinical physicians in next diagnosis and treatment decisions.

Key words: respiratory distress syndrome, ultrasonography, extravascular lung water, cardiac function