Usefulness of Lung Ultrasonography for Diagnosis of Pneumonia After Major Cardiac Surgery: a Pilot Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 51
- 主要终点
- Final diagnosis of pneumonia
研究概览
简要总结
Diagnosis of pneumonia remains difficult in intensive care unit (ICU), notably after cardiac surgery. Lung ultrasonography (LUS) has been successfully used for diagnosis of pneumonia, but its usefulness and reliability was never evaluated after cardiac surgery. This study investigates the clinical relevance of LUS for pneumonia diagnoses in cardiac ICU.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 99 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Cardiac surgery with sternotomy and cardio-pulmonary bypass (CPB) less than 3 days before
- •At least one component suggestive of ARF:
- •If mechanical ventilation, a PaO2 / FiO2 ratio <200, or failure of weaning (failure of spontaneous ventilation test, re-intubation in the first 24 hours), or need for non-invasive ventilation immediately after extubation,
- •If spontaneous ventilation: clinical signs of acute respiratory distress (dyspnea at least exertion, cyanosis, polypnea> 25/min, upper or intercostal swallowing, abdominal swing ...), SpO2 < 90% or PaO2 <60 mmHg despite oxygen therapy ≥ 3L/min.
排除标准
- •Minor patients
- •Pregnancy
- •Sleep apnea syndrome
- •Participation refusal
结局指标
主要结局
Final diagnosis of pneumonia
时间窗: During the 72 hours following surgery
Pneumonia or excluded pneumonia, was determined by consensus of 3 investigators, after an independent post hoc review of the medical records. Pneumonia diagnosis was based on concordance of clinical and radiological criteria (≥ 2 criteria including fever\> 38.5 ° C or T \<36 ° C, leukocytosis\> 10 \^ 9 / L or leukopenia \<4.10 \^ 8 / L, purulent tracheal secretions and the appearance or persistence of an infiltrate on the CXR). It should be confirmed by culture of a respiratory specimen: protected distal sampling with a threshold of significance ≥ 10 \^ 3 colony forming unit/mL or bronchoalveolar lavage with a threshold of significance ≥ 10 \^ 4 CFU/mL.
次要结局
未报告次要终点
研究者
Adrien Bouglé
Principal Investigator
Groupe Hospitalier Pitie-Salpetriere