LUNG ULTRASOUND DERIVED INSIGHTS IN VENTILATOR ASSOCIATED PNEUMONIA

Abstract

Lung Ultrasound (LUS) is widely used in diagnosis and monitoring of Ventilator Associated Pneumonia (VAP). The aim of our study is to evaluate and detect local lung events in mechanically ventilated patients, as well as to evaluate the usage of LUS in distinguishing VAP from Ventilator associated tracheobronchitis. We examined LUS finings in all patients who fulfilled the criteria for VAP, and stratified them according to the CLUE Protocol. We have examined the findings for VPLUS Score of each patient and tried to find a correlation between LUS Score and VPLUS Score. The average value of total LUSS of all patients examined was 11.05. LUS Score of the upper segments versus lower segments was 0.07 versus 2.1 respectively with 95% CI from 1.44 to 2.61, and significance level p<0.0001 suggesting the existence of statistically significant difference into distribution of pathological findings in between upper versus lower lung segments. Also, we found a LUS Scores difference of 3.46 with 95%CI of 0.95 to 5.96 and significance level of p=0.0099 which implies existence of statistically significant higher LUS Score values in patients with VPLUS >2 versus patients with VPLUS of 2. In conclusion, the pathological findings in patients with VAP were distributed in the dependent regions, while upper segments were spared. Also, only patients with VPLUS>2 instead of VPLUS≥2 should be considered as having VAP.