Integrated cardiopulmonary sonography: a useful tool for assessment of acute pulmonary edema in the intensive care unit.
OBJECTIVES
Bedside sonography has become a popular method of assessment of critically ill patients with shock and dyspnea. This study evaluated the usefulness of integrated cardiopulmonary sonography for assessment of acute pulmonary edema.


METHODS
A total of 128 intensive care unit (ICU) patients with acute pulmonary edema were randomly divided into 2 groups: a sonography group, which received standard treatment as well as cardiopulmonary sonography, and a control group, which received standard treatment only. All patients were treated according to the same therapeutic strategies and underwent chest radiography and central venous catheter placement. Serum myocardial injury marker levels and central venous/arterial blood gas parameters were measured 0, 24, and 72 hours after enrollment. The cumulative fluid infusion volume at 6, 12, 24, and 72 hours, the time to diagnosis of the pulmonary edema etiology by the attending physician, the lengths of ICU and hospital stays, and ICU mortality were recorded.


RESULTS
The sonography group had a shorter time to diagnosis and received a smaller fluid infusion volume than the control group. There were no significant differences in ICU mortality and lengths of ICU and hospital stays between the sonography and control groups. In patients with cardiogenic pulmonary edema, the sonography group had a significantly shorter ICU stay and a faster return to normal myocardial injury marker levels and perfusion parameters than the control group (P < .05).


CONCLUSIONS
Integrated cardiopulmonary sonography resulted in faster and better-informed clinical decision making, shortened the time to diagnosis of the pulmonary edema etiology, and decreased fluid use. However, the impact of this examination on prognoses requires further study. We propose that integrated cardiopulmonary sonography may be a useful bedside tool for treatment of ICU patients with acute pulmonary edema.
['Wang|Xiao-Ting|XT|', 'Liu|Da-Wei|DW|', 'Zhang|Hong-Min|HM|', 'Chai|Wen-Zhao|WZ|']
D018806:APACHE D000208:Acute Disease D000328:Adult D002405:Catheterization, Central Venous D016638:Critical Illness D004452:Echocardiography D006801:Humans D007362:Intensive Care Units D019344:Lactic Acid D007902:Length of Stay D008168:Lung D009200:Myocardial Contraction D010100:Oxygen D019095:Point-of-Care Systems D011654:Pulmonary Edema D014682:Vena Cava, Inferior D055815:Young Adult
sonography acute pulmonary edema etiology critical care point-of-care ultrasound prognosis