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| Impact of lung ultrasound on treatment and prognosis in patients with acute left heart failure |
| Ding Qi, Wang Shu-hong, Huang Xin-xin, Feng Ye-zi, Zhang Huan-huan, Huang Qiong, Yu Hui-juan, Yuan Yi-qiang |
| Department of Cardiology, Zhengzhou No.7 People′s Hospital, Zhengzhou 450000, China |
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Abstract Objective To investigate whether lung ultrasound could optimize treatment and improve prognosis in patients with acute left heart failure. Methods We prospectively enrolled a consecutive series of 225 patients hospitalized with acute left heart failure from November 2015 to February 2017 in our department, whom were randomly divided into ultrasound guided group (n=113) and conventional treatment group (n=112), the conventional treatment group received standardized treatment according to guidelines, the ultrasound guided group received treatment guided by lung ultrasound on the basis of conventional treatment, we investigated the adverse events during hospitalization and follow-up for 13 months. Results During hospitalization, the proportion of acute kidney injury［23.0% (26/113) vs. 33.9% (38/112), P＜0.05］, cardiac shock［10.7% (12/113) vs. 23.2% (26/112), P＜0.01］, length of stay［(2.3±0.2) days vs. (3.7±0.3) days, P＜0.001］and cost［(6674.5±1143.6) yuan vs. (8759.7±1257.4) yuan, P＜0.05］in CCU, daily dose of diuretic［(36.6±8.4) mg vs. (68.6±11.7) mg, P＜0.001］were lower in ultrasound guided group compared with conventional treatment group, there were no differences in all-cause mortality, malignant arrhythmia, daily fluid infusion volume and lactate clearance within 24 hours between the two groups (P>0.05). During follow-up, the proportion of symptomatic heart failure［37.2% (42/113) vs. 48.2% (54/112), P＜0.05］, readmission because of heart failure［19.5%(22/113) vs. 40.2%(45/112), P＜0.01］, renal failure rely on renal replacement therapy［3.5%(4/113) vs. 11.6%(13/112), P＜0.001］were lower in ultrasound guided group compared with conventional treatment group, there were no differences in all-cause mortality between the two groups［13.3%(15/113) vs. 18.8%(21/112), P=0.157］. Conclusion Application of lung ultrasound can reduce acute kidney injury, cardiac shock, length of stay and cost in CCU during hospitalization, and the relapse of heart failure, readmission, renal failure need renal replacement therapy after discharge, can′t reduce short-term and long-term mortality.
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Corresponding Authors:
Wang Shu-hong, E-mail: wsh1183@163.com
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