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Pulmonary ultrasound scoring system for intubated critically ill patients and its association with clinical metrics and mortality: A prospective cohort study
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  • David M. Tierney MD,
  • Lori L. Boland MPH,
  • Josh D. Overgaard MD,
  • Joshua S. Huelster MD,
  • Ann Jorgenson RN,
  • James P. Normington MS,
  • Roman R. Melamed MD
David M. Tierney MD
Author Profile
Lori L. Boland MPH
Josh D. Overgaard MD
Joshua S. Huelster MD
Ann Jorgenson RN
James P. Normington MS
Roman R. Melamed MD


Purpose : Pulmonary ultrasound can rapidly identify the etiology of acute respiratory failure (ARF) and assess treatment response. The often-subjective classification of abnormalities makes it difficult to document change over time and communicate findings across providers. The study goal was to develop a simple, scoring system that would allow for standardized documentation, have high inter-provider agreement, and correlate with clinical metrics.Methods : rospective of adults intubated for ARF performed at intubation, 48-hours, and extubation. A total lung score (TLS) was calculated. Clinical metrics and final diagnosis were extracted from the medical record.Results : TLS correlated positively with mortality (p=0.0), ventilator hours (p0.00), intensive care unit and hospital length of stay (p=0.00, p=0.0), and decreasing PaO2/FiO2 (p0.00). Agreement of findings was very good (kappa=0.83). Baseline TLS differed significantly between ARF categories (non-pulmonary, obstructive, and parenchymal disease).Conclusions : A quick, was associated with clinical metrics including mortality among a diverse population of patients intubated for ARF. In addition to diagnostic and prognostic information at the bedside, a standardized and quantifiable approach to PU provides objectivity in serial assessment and may enhance communication of findings between providers.

Peer review status:Published

Published in Journal of Clinical Ultrasound, Volume 46, Issue 1. Jan 2018. 10.1002/jcu.22526