Puntaje radiográfico de evaluación del edema pulmonar (RALE) y su asociación con desenlaces clínicos en el síndrome de dificultad respiratoria aguda en Colombia

Abstract

Introduction Acute respiratory distress syndrome (ARDS) is currently the main diagnosis in intensive care units (ICU) and is related to the SARS-CoV-2 pandemic. This syndrome increases hospital stay and costs, and has high mortality. Chest radiography is essential in these patients for diagnosis and clinical follow-up, as it is inexpensive and routinely used in the ICU. The RALE score (Radiographic assessment of lung edema) allows the estimation of the extension and density of alveolar opacities in chest radiography and has been associated with different clinical outcomes such as oxygenation, mortality at 28 days, ventilator-free days, hospital stay, and severity of ARDS. The objective of this work is to establish the association of RALE with clinical outcomes in patients with ARDS in our institution.

Materials and methods Ambispective, monocentric cohort study. Adults older than 18 years with a diagnosis of ARDS hospitalized in the ICUs of Hospital Santa Clara, Bogotá, Colombia, from January to December 2020, were included.

Results The study included 100 patients, 93% with a diagnosis of SARS-CoV-2, an association with RALE on the first day was found with oxygenation on the first day of admission, but without finding a statistically significant relationship between RALE and the other outcomes.

Conclusion The RALE score was not associated with relevant clinical outcomes in patients with ARDS. This can be explained by the different mechanisms of hypoxaemia in these patients. Further studies are suggested to confirm these findings.