| Ultrasound assessment of antibiotic-induced pulmonary reaeration in ventilator-associated pneumonia. | |
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MedLine Citation:
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PMID: 19633538 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To compare lung reaeration measured by bedside chest radiography, lung computed tomography, and lung ultrasound in patients with ventilator-associated pneumonia treated by antibiotics. DESIGN: Computed tomography, chest radiography, and lung ultrasound were performed before (day 0) and 7 days following initiation of antibiotics. SETTING: A 26-bed multidisciplinary intensive care unit in La Pitié-Salpêtrière hospital (University Paris-6). PATIENTS:: Thirty critically ill patients studied over the first 10 days of developing ventilator-associated pneumonia. INTERVENTIONS:: Antibiotic administration. MEASUREMENTS AND MAIN RESULTS: Computed tomography reaeration was measured as the additional volume of gas present within both lungs following 7 days of antimicrobial therapy. Lung ultrasound of the entire chest wall was performed and four entities were defined: consolidation; multiple irregularly spaced B-lines; multiple abutting ultrasound lung "comets" issued from the pleural line or a small subpleural consolidation; normal aeration. For each of the 12 regions examined, ultrasound changes were measured between day 0 and 7 and a reaeration score was calculated. An ultrasound score >5 was associated with a computed tomography reaeration >400 mL and a successful antimicrobial therapy. An ultrasound score <-10 was associated with a loss of computed tomography aeration >400 mL and a failure of antibiotics. A highly significant correlation was found between computed tomography and ultrasound lung reaeration (Rho = 0.85, p < .0001). Chest radiography was inaccurate in predicting lung reaeration. CONCLUSIONS: Lung reaeration can be accurately estimated with bedside lung ultrasound in patients with ventilator-associated pneumonia treated by antibiotics. Lung ultrasound can also detect the failure of antibiotics to reaerate the lung. |
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Authors:
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Bélaïd Bouhemad; Zhi-Hai Liu; Charlotte Arbelot; Mao Zhang; Fabio Ferarri; Morgan Le-Guen; Martin Girard; Qin Lu; Jean-Jacques Rouby |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 38 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-22 Completed Date: 2010-01-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 84-92 Citation Subset: AIM; IM |
Affiliation:
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Réanimation Polyvalente Pierre Viars, Department of Anesthesiology and Critical Care, Hôpital de la Pitié-Salpêtrière Assistance Publique Hôpitaux de Paris, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anti-Bacterial Agents / therapeutic use* Cohort Studies Confidence Intervals Critical Care Female Follow-Up Studies Humans Intensive Care Units Male Middle Aged Pneumonia, Ventilator-Associated / drug therapy*, radiography, ultrasonography* Point-of-Care Systems* Probability Prospective Studies Radiography, Thoracic / methods Risk Assessment Sensitivity and Specificity Severity of Illness Index Tomography, X-Ray Computed / methods Treatment Outcome Ultrasonography, Doppler / methods* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 2010 Jan;38(1):308-9
[PMID:
20023475
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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