الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 147 |  |  |
| | | from | 147 | | |
Abstract
This prospective, observational, cohort research was conducted at the intensive care unit of Minia University Hospital in June 2021 & December 2022 on 30 studied cases who had been diagnosed with ARDS for different causes after obtaining consent from the studied case’s next of kin.
This was done after research protocol approval by the Ethics Committee of Minia University (Approval No. 694:12/2020).
30 Patients fulfilling the criteria of Berlin’s definition of ARDS involving acute onset, bilateral radiographic opacities, arterial hypoxemia, and exclusion of any cardiac causes & admitted in ICU had been contained in the research.
1- Full history was taken from 1st-degree relative, including name, age, medical and surgical history.
2- Physical and clinical examinations are then done with complete monitoring including (Blood pressure measurement, ECG electrodes, and pulse oximeter).
3- Chest x-ray and chest CT if possible.
4- Blood samples for IL-6 & IL-8: had been collected on the day of admission. The 2nd serum samples for IL-6 & IL-8 were collected on day 3 and the 3rd samples on day 7.
5- Other Lab. Investigations to be observed on the same 3 days (admission, day 3, day 7):
• TLC, Urea, Creatinine, ALT, and AST.
• PaO2/FiO2 is very important
6- LUS: consisted of a scan of twelve different regions 6 for hemithorax, 2 anterior, 2 lateral, & 2 posterior thoracic regions, each divided into superior & inferior. Each region had been scored, LUSS maybe 0 (normal aeration) up to 36 (consolidation of all regions).
7- Management:
• Mechanical ventilation or not
• Pharmacotherapy
• Supportive treatment
The study revealed:
• MAP, HR, and SpO2 readings were the highest on admission day. However, RR was the highest on day 7. SpO2 readings increase in the good prognosis patients from the admission day to day 7 but decrease in the other group of bad prognoses. RR is the reverse.
• PaO2/FiO2 decreased from the admission day to day 7. However, it increased in the hopeful patients over the days of the study but decreased in the other bad group.
Laboratory investigations:
• TLC decreased in the good prognosis group over the study days but increased in the other bad prognosis group.
• Urea, creatinine, ALT, & AST showed increasing levels in the bad prognosis patients while decreasing in the good prognosis from admission day to day 7
• In the improving patients, serum IL-6 & IL-8 increased from the day of admission to day3 & then decreased on day7. On the other side, in the deteriorating patient, it continued to increase on day 7.
• LUSS decreased in the good prognosis group but increased in the bad prognosis.
• On admission day, there is a moderate positive link between IL-6 & IL-8 (r=0.731, P <0.001), but no relation between IL-6 and LUSS (r=-0.010, P 0.958) nor between IL-8 with LUSS (r=-0.243, P 0.196).
• On day 3, there is a strong positive link between IL-6 & IL-8 (r=0.760, P <0.001), but no relation between IL-6 and LUSS (r=0.023, P 0.904) nor between IL-8 with LUSS (r=-0.160, P 0.400).
• On day 7, there is a strong positive link between IL-6 and IL-8 (r=0.861, P <0.001), and a moderate positive link with LUSS (r=0.595, P 0.001). Also, a moderate positive relationship among IL-8 & LUSS (r=0.665, P<0.001).
• On day 3, there had been a negative moderate relationship among LUSS & PaO2/FiO2 (r=-0.749, P <0.001).
• On day7, there had been a negative moderate relationship among PaO2/FiO2 & IL-6 (r=-0.626, P <0.001), also with IL-8 (r=-0.655, P <0.001), & strongly negative associated with LUSS (r=-0.879, P <0.001).