INTRODUCTION AND NEED FOR THE STUDY

Acute respiratory distress syndrome (ARDS), characterized by increased lung weight and loss of lung aeration, is a life-threatening condition. According to the recently published literature, significant mortality reduction in ARDS patients have been obtained when prone position (PP)is utilized as an adjunct to lung protective ventilation.

Lung Ultrasound

Lung ultrasound has become an attractive new tool for assessing lung status in ventilated critically ill patients, as suggested by the increasing number of articles written about it by physicians practicing in chest, intensive care or emergency medicine. As a matter of fact, chest ultrasound can be used easily at the bedside to assess initial lung morphology in severely hypoxemic patients and can be easily repeated, allowing the effects of therapy to be monitored. Lung ultrasound (LUS) has been proposed as an alternative bedside imaging technique. Ex vivo, LUS artifacts changed with the progressive increase in lung density. In a controlled human model of lung air content variation, LUS reliably recorded the changes in lung aeration.

In this prospective, cross-sectional, observational study we will evaluate a sample size of 50 patient admitted in ICU as moderate to severe ARDS with aim to evaluate alteration in lung density with the help of LUS and its correlation with oxygenation and outcomes in patients with ARDS. Our Objective of this study will be to assess changes in lung aeration with LUS in patient with ARDS and correlate change in oxygenation in lung aeration.

LUS will be performed according to international guidelines. We will used 1–5 MHz convex probes. All intercostal spaces of the upper and lower parts of the anterior, lateral, and posterior areas of the left and right chest wall will be examined. (Figure 1) Four LUS exams will be performed for each patient 1 h before and after each reversal. Data will be collected 1 h before PP(LUS 1), 1 h after PP (LUS 2), 1 h before the patient was turned back to the supine position (LUS 3), and 1 h after the patient was returned to the supine position (LUS 4).

So all the data collected will be evaluated and statistical analysis will be done by an independent statistician.