ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Lung Ultrasound B‑lines Predict Adverse Clinical Outcomes in Adults with Sepsis in a Resource‑Limited Emergency Department
Kamonwon Ienghong 1
Korakot Apiratwarakul 1
Dhanu Gaysonsiri 1
Lap Woon Cheung 2
1. Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
2. The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong, SAR China
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Abstract
Background: Sepsis increases the risk of acute respiratory distress syndrome (ARDS) and other respiratory complications. Point-of-care lung ultrasound (POCUS) detection of B‑lines may facilitate early risk stratification where advanced imaging is limited. This study evaluated the association between B‑lines on lung ultrasound and clinical outcomes in adult sepsis patients treated in a resource‑limited emergency department. Methods: A retrospective observational study was conducted on sepsis patients treated in the emergency department from January to December 2024. Ultrasound documentation and electronic medical records were analyzed to compare overall mortality, hospital length of stay, and mechanical ventilator use between patients with and without B-lines. Primary outcomes were in‑hospital mortality, mechanical ventilator use, and hospital length of stay. Descriptive statistics compared outcomes between patients with and without B‑lines. Multivariable logistic regression was used to estimate the adjusted association between B‑lines and hospital mortality, controlling for clinically relevant confounders. Results: Among 184 sepsis patients, 56 (30.43%) exhibited B-lines on lung ultrasound, confirming a diagnosis of ARDS. Mortality rates (16.07% vs. 4.68%, p<0.001), mechanical ventilation use (39.28% vs. 7.03%, p<0.001), and median hospital stay duration (11 vs. 6 days, p<0.001) were compared between the B-lines group and the non-B-lines group. In the multivariable logistic regression analysis, the B-lines group exhibited a significantly higher hospital mortality rate (adjusted odds ratio, 4.6; 95% confidence interval, 2.5-5.5) compared to the non-B-lines group. Conclusion: The presence of B-lines on lung ultrasound in sepsis patients is significantly associated with increased mortality, higher rates of mechanical ventilation, and prolonged hospital stays. These findings support the potential utility of POCUS B‑line assessment for early risk stratification in resource‑limited emergency settings.
Summary
Keywords
emergency service, HealthResources, Sepsis, treatment outcome, Ultrasonography
Received
12 January 2026
Accepted
10 February 2026
Copyright
© 2026 Ienghong, Apiratwarakul, Gaysonsiri and Cheung. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Korakot Apiratwarakul
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