What does this research mean for the field?

Electronic stethoscope auscultation findings correlate with echocardiographic parameters and provide prognostic value for mortality and ICU length of stay in ARDS patients. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

The study aims to examine the relationship between cardiac auscultation and echocardiographic findings in ARDS patients requiring mechanical ventilation, as well as their prognostic significance for mortality.

March 3, 2026Open Access

Electronic Stethoscope Auscultation and Echocardiography in ARDS: Correlation and Prognostic Value for Mortality and ICU Length of Stay: A Prospective Observational Study

Key Points

The study aims to examine the relationship between cardiac auscultation and echocardiographic findings in ARDS patients requiring mechanical ventilation, as well as their prognostic significance for mortality.
Conducted a prospective observational study enrolling 173 ARDS patients on mechanical ventilation.
Used electronic stethoscope to perform cardiac auscultation at four valvular positions.
Assessed ventricular function, valvular regurgitation, and right ventricular systolic pressure via bedside echocardiography.
Analyzed outcomes related to ICU mortality and length of stay.
ICU mortality was found to be 42.2% and 90-day mortality was 46.8%.
Significant correlation observed between auscultation findings and echocardiographic parameters, such as aortic stenosis murmur and elevated aortic valve velocity.
Mean daily SOFA score and RVSP were independent predictors of ICU mortality.
For 90-day mortality, APACHE II score and mitral regurgitation severity were significant predictors.
Mean daily SOFA score and tricuspid regurgitation severity predicted ICU length of stay.

Abstract

Background and Objectives: Acute respiratory distress syndrome (ARDS) carries high mortality, with cardiovascular complications frequently contributing to adverse outcomes. This study investigated the relationship between cardiac auscultation using electronic stethoscopy and echocardiographic findings and evaluated their prognostic significance in mechanically ventilated ARDS patients. Materials and Methods: This prospective observational study enrolled 173 consecutive adults with ARDS requiring mechanical ventilation (June 2020–June 2021). Cardiac auscultation was performed using an electronic stethoscope at four standard valvular positions. Bedside echocardiography assessed ventricular function, valvular regurgitation, right ventricular systolic pressure (RVSP), and inferior vena cava dimensions. Primary outcomes were ICU and 90-day mortality; the secondary outcome was ICU length of stay. Results: ICU mortality was 42.2% and 90-day mortality 46.8%. Auscultation findings correlated significantly with echocardiographic parameters: aortic stenosis murmur with an elevated aortic valve velocity (p = 0.009), and mitral/tricuspid regurgitation murmurs with corresponding color Doppler findings (p < 0.001). In multivariate analysis, the mean daily SOFA score (OR 2.39, 95% CI 1.57–3.64, p < 0.001) and RVSP (OR 1.07, 95% CI 1.02–1.11, p = 0.006) independently predicted ICU mortality. For 90-day mortality, the APACHE II score (OR 1.25, p = 0.006), mean daily SOFA score (OR 1.54, p = 0.039), RVSP (OR 1.07, p = 0.020), and mitral regurgitation severity (OR 2.98, p = 0.031) were independent predictors. ICU length of stay was predicted by the mean daily SOFA score (r = 0.35, p < 0.001) and tricuspid regurgitation severity (r = 0.25, p = 0.012). Conclusions: Electronic stethoscope auscultation correlates with the echocardiographic findings in ARDS patients. The RVSP and SOFA scores independently predict mortality, while valvular regurgitation severity provides additional prognostic information for long-term survival and ICU resource utilization.

Electronic Stethoscope Auscultation and Echocardiography in ARDS: Correlation and Prognostic Value for Mortality and ICU Length of Stay: A Prospective Observational Study

Key Points

Abstract

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