Pleural Effusion Identified by Point of Care Ultrasound (POCUS) in Septic Shock: Impact on Clinical Outcomes
Aim: To analyze the association between pleural effusion detected by chest point of care ultrasound (POCUS) and clinical outcomes in patients with septic shock admitted to an intensive care unit (ICU). Material and methods: A prospective evaluation of ICU patients with septic shock in whom chest PO...
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| Format: | Article |
| Language: | English |
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CINQUILL Medical Publishers Inc.
2024-11-01
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| Series: | POCUS Journal |
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| Online Access: | https://ojs.library.queensu.ca/index.php/pocus/article/view/17293 |
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| author | Erick Joel Rendón-Ramirez Andrés Mauricio Morales-García Adrián Rendón-Pérez Homero Nañez-Terreros Ricardo César Solis Alexandra Daniela Magaña-García Samantha Medrano-Juárez José Francisco Caloca-Estrada Roberto Mercado-Longoria Jorge Eduardo Leija-Herrera José M Porcel |
| author_facet | Erick Joel Rendón-Ramirez Andrés Mauricio Morales-García Adrián Rendón-Pérez Homero Nañez-Terreros Ricardo César Solis Alexandra Daniela Magaña-García Samantha Medrano-Juárez José Francisco Caloca-Estrada Roberto Mercado-Longoria Jorge Eduardo Leija-Herrera José M Porcel |
| author_sort | Erick Joel Rendón-Ramirez |
| collection | DOAJ |
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Aim: To analyze the association between pleural effusion detected by chest point of care ultrasound (POCUS) and clinical outcomes in patients with septic shock admitted to an intensive care unit (ICU). Material and methods: A prospective evaluation of ICU patients with septic shock in whom chest POCUS was performed during the first 24 hours of diagnosis to identify the presence and characteristics of pleural effusion. Results: Of 45 patients with septic shock, 17 (38%) had pleural effusion. Mortality (13 vs 17 patients, p=0.44), as well as length of stay in ICU (11.0 vs 6.5 days, p=0.161) were similar among groups. However, there was a significant difference in the modified Nutrition Risk in Critically Ill (mNUTRIC) score between the pleural effusion (5.82±1.13) and non-pleural effusion groups (4.00±2.39, p=0.001). In addition, patients with pleural effusion required more days on mechanical ventilation than those without pleural effusion (10 vs 7, p=0.04). A subgroup analysis of chest POCUS characteristics between surviving and non-surviving patients with pleural effusion identified a higher median size of pleural effusion in the non-surviving group (3±2.16 cm vs 1.9±0.6, p=0.01). Conclusion: Pleural effusion in patients with septic shock is associated with high mNUTRIC scores and more days on mechanical ventilation. The larger the pleural effusion, the lower the survival rate.
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| format | Article |
| id | doaj-art-37a87b058f7049b1a62daeddeb87baf8 |
| institution | Kabale University |
| issn | 2369-8543 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | CINQUILL Medical Publishers Inc. |
| record_format | Article |
| series | POCUS Journal |
| spelling | doaj-art-37a87b058f7049b1a62daeddeb87baf82024-11-17T05:00:02ZengCINQUILL Medical Publishers Inc.POCUS Journal2369-85432024-11-019210.24908/pocus.v9i2.17293Pleural Effusion Identified by Point of Care Ultrasound (POCUS) in Septic Shock: Impact on Clinical OutcomesErick Joel Rendón-Ramirez0https://orcid.org/0000-0003-2648-7454Andrés Mauricio Morales-García1Adrián Rendón-Pérez2https://orcid.org/0000-0001-8973-4024Homero Nañez-Terreros3Ricardo César Solis4https://orcid.org/0000-0001-7206-6955Alexandra Daniela Magaña-García5https://orcid.org/0009-0000-8841-6163Samantha Medrano-Juárez6https://orcid.org/0000-0001-7216-7828José Francisco Caloca-Estrada7Roberto Mercado-Longoria8Jorge Eduardo Leija-Herrera9https://orcid.org/0009-0008-1385-7448José M Porcel10https://orcid.org/0000-0002-2734-8061Servicio de Neumología y Cuidados Intensivos, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, CIPTR, Monterrey, NL, México; Departamento de Medicina Interna, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, NL, México; Unidad de Pleura y Ecografía Torácica, Servicio de Neumología y Cuidados Intensivos, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, NL, México Servicio de Neumología y Cuidados Intensivos, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, CIPTR, Monterrey, NL, MéxicoServicio de Neumología y Cuidados Intensivos, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, CIPTR, Monterrey, NL, México; Departamento de Medicina Interna, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, NL, México Servicio de Neumología y Cuidados Intensivos, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, CIPTR, Monterrey, NL, MéxicoServicio de Neumología y Cuidados Intensivos, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, CIPTR, Monterrey, NL, México; Unidad de Pleura y Ecografía Torácica, Servicio de Neumología y Cuidados Intensivos, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, NL, MéxicoUnidad de Pleura y Ecografía Torácica, Servicio de Neumología y Cuidados Intensivos, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, NL, MéxicoUnidad de Pleura y Ecografía Torácica, Servicio de Neumología y Cuidados Intensivos, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, NL, MéxicoUnidad de Pleura y Ecografía Torácica, Servicio de Neumología y Cuidados Intensivos, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, NL, MéxicoServicio de Neumología y Cuidados Intensivos, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, CIPTR, Monterrey, NL, MéxicoUnidad de Pleura y Ecografía Torácica, Servicio de Neumología y Cuidados Intensivos, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, NL, MéxicoPleural Medicine and Clinical Ultrasound Unit, Departament of Internal Medicine, Hospital Universitario Arnau de Villanova, IRBLleida, Lleida, España Aim: To analyze the association between pleural effusion detected by chest point of care ultrasound (POCUS) and clinical outcomes in patients with septic shock admitted to an intensive care unit (ICU). Material and methods: A prospective evaluation of ICU patients with septic shock in whom chest POCUS was performed during the first 24 hours of diagnosis to identify the presence and characteristics of pleural effusion. Results: Of 45 patients with septic shock, 17 (38%) had pleural effusion. Mortality (13 vs 17 patients, p=0.44), as well as length of stay in ICU (11.0 vs 6.5 days, p=0.161) were similar among groups. However, there was a significant difference in the modified Nutrition Risk in Critically Ill (mNUTRIC) score between the pleural effusion (5.82±1.13) and non-pleural effusion groups (4.00±2.39, p=0.001). In addition, patients with pleural effusion required more days on mechanical ventilation than those without pleural effusion (10 vs 7, p=0.04). A subgroup analysis of chest POCUS characteristics between surviving and non-surviving patients with pleural effusion identified a higher median size of pleural effusion in the non-surviving group (3±2.16 cm vs 1.9±0.6, p=0.01). Conclusion: Pleural effusion in patients with septic shock is associated with high mNUTRIC scores and more days on mechanical ventilation. The larger the pleural effusion, the lower the survival rate. https://ojs.library.queensu.ca/index.php/pocus/article/view/17293Pleural effusionSeptic ShockIntensive CareNUTRICPOCUS |
| spellingShingle | Erick Joel Rendón-Ramirez Andrés Mauricio Morales-García Adrián Rendón-Pérez Homero Nañez-Terreros Ricardo César Solis Alexandra Daniela Magaña-García Samantha Medrano-Juárez José Francisco Caloca-Estrada Roberto Mercado-Longoria Jorge Eduardo Leija-Herrera José M Porcel Pleural Effusion Identified by Point of Care Ultrasound (POCUS) in Septic Shock: Impact on Clinical Outcomes POCUS Journal Pleural effusion Septic Shock Intensive Care NUTRIC POCUS |
| title | Pleural Effusion Identified by Point of Care Ultrasound (POCUS) in Septic Shock: Impact on Clinical Outcomes |
| title_full | Pleural Effusion Identified by Point of Care Ultrasound (POCUS) in Septic Shock: Impact on Clinical Outcomes |
| title_fullStr | Pleural Effusion Identified by Point of Care Ultrasound (POCUS) in Septic Shock: Impact on Clinical Outcomes |
| title_full_unstemmed | Pleural Effusion Identified by Point of Care Ultrasound (POCUS) in Septic Shock: Impact on Clinical Outcomes |
| title_short | Pleural Effusion Identified by Point of Care Ultrasound (POCUS) in Septic Shock: Impact on Clinical Outcomes |
| title_sort | pleural effusion identified by point of care ultrasound pocus in septic shock impact on clinical outcomes |
| topic | Pleural effusion Septic Shock Intensive Care NUTRIC POCUS |
| url | https://ojs.library.queensu.ca/index.php/pocus/article/view/17293 |
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