Transesophageal lung ultrasound score is associated with arterial oxygenation and clinical outcomes in mechanically ventilated critically ill patients

Non-survivors had significantly higher TELUS scores compared to survivors (median 5 [IQR 4-6] vs. 4 [3-5], P = 0.001). Regional TELUS scores at the upper-aortic arch level and mid-esophageal level were elevated in non-survivors (P = 0.018 and P = 0.004, respectively). TELUS scores showed a significantly negative correlation with the PaO₂/FiO₂ ratio (r = -0.51, P < 0.0001), and positive correlations with PEEP (r = 0.32, P = 0.007) and SOFA scores (r = 0.26, P = 0.032). Multivariate analysis identified both SOFA (OR 1.31, 95% CI 1.08-1.63, P = 0.009) and TELUS scores (OR 1.72, 95% CI 1.08-2.96, P = 0.030) as independent predictors of 28-day mortality. ROC analysis showed that a TELUS score ≥ 4 predicted 28-day mortality and severe hypoxemia (PaO₂/FiO₂ ≤ 100), yielding areas under the ROC (AUCs) of 0.74 and 0.72, with high sensitivity (89% and 100%, respectively) and negative predictive values (92% and 100%, respectively.) CONCLUSION: TELUS is a feasible novel technique that provides a reliable assessment of posterior lung aeration in critically ill patients. TELUS scoring correlates with impaired oxygenation and is independently associated with 28-day mortality. These findings highlight the prognostic value of TELUS and support its potential integration into transesophageal cardiopulmonary ultrasound protocols.