Accuracy of Resident‐Performed Point‐of‐Care Lung Ultrasound Examinations Versus Chest Radiography in Pneumothorax Follow‐up After Tube Thoracostomy in Rwanda

Shumbusho, Jean Paul; Duanmu, Youyou; Kim, Sung H.; Bassett, Ingrid V.; Boyer, Edward W.; Ruutiainen, Alexander T.; Riviello, Robert; Ntirenganya, Faustin; Henwood, Patricia C.

doi:10.1002/jum.15126

Cited by 11 publications

(9 citation statements)

References 27 publications

(82 reference statements)

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“…33 Several of the findings (especially B-lines) have excellent interrater reliability and can be expediently learned. 30,34,35 Based on the results of this study, a rapid assessment of the anterior lungs may provide sufficient risk stratification and warrants further study.…”

Section: Discussionmentioning

confidence: 90%

Point-of-Care Ultrasound (POCUS) Predicts Clinical Outcomes in Patients with COVID-19

Kumar

Weng

Graglia

et al. 2021

Preprint

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Introduction: Point-of-care ultrasound (POCUS) may detect the cardiopulmonary manifestations of COVID-19 and expediently predict patient outcomes. Methods: We conducted a prospective cohort study at four medical centers from 3/2020-1/2021 to evaluate POCUS findings and clinical outcomes with COVID-19. Our inclusion criteria included adult patients hospitalized for COVID-19 who received cardiac or lung POCUS with a 12-zone protocol. Images were interpreted by two reviewers blinded to clinical outcomes. Our primary outcome was ICU admission incidence. Secondary outcomes included intubation and supplemental oxygen usage. Results: N=160 patients (N=201 scans) were included. Scans were collected a median 23 hours (IQR:7-80) from emergency department triage. Triage POCUS findings associated with ICU admission included B-lines (OR 4.41 [95% CI:1.71-14.30]; p<0.01) or consolidation (OR 2.49 [95% CI:1.35-4.86]; p<0.01). B-lines were associated with intubation (OR 3.10 [95% CI:1.15-10.27]; p=0.02) and supplemental oxygen usage (OR 3.74 [95% CI:1.63-8.63; p<0.01). Consolidations present on triage were associated with the need for oxygen at discharge (OR 2.16 [95% CI: 1.01-4.70]; p=0.047). A normal lung triage scan was protective for ICU admission (OR 0.28 [95% CI:0.09-0.75; p<0.01) or need for supplemental oxygen during the hospitalization (OR 0.26 [95% CI:0.11-0.61]; p<0.01). Triage cardiac POCUS scans were not associated with any outcomes. Discussion: Lung POCUS findings detected early in the hospitalization may provide expedient risk stratification for important COVID-19 clinical outcomes, including ICU admission, intubation, or need for oxygen on discharge. A normal admission scan appears protective against adverse outcomes, which may aid in triage decisions of patients.

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Section: Discussionmentioning

confidence: 90%

Point-of-Care Ultrasound (POCUS) Predicts Clinical Outcomes in Patients with COVID-19

Kumar

Weng

Graglia

et al. 2021

Preprint

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“…The diagnosis of PTX using LUS is relatively easy when guiding principles are followed. Formal LUS training allows trainees to quickly acquire these skills 50 .…”

Section: Discussionmentioning

confidence: 99%

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Liu¹,

Kurepa

Feletti

et al. 2020

JoVE

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Pneumothorax (PTX) represents accumulation of the air in the pleural space. A large or tension pneumothorax can collapse the lung and cause hemodynamic compromise, a life-threatening disorder. Traditionally, neonatal pneumothorax diagnosis has been based on clinical images, auscultation, transillumination, and chest X-ray findings. This approach may potentially lead to a delay in both diagnosis and treatment. The use of lung US in diagnosis of PTX together with US-guided thoracentesis results in earlier and more precise management. The recommendations presented in this publication are aimed at improving the application of lung US in guiding neonatal PTX diagnosis and management.

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“…Importantly, our findings suggest that the high‐risk features for COVID‐19 are located primarily in the anterior or lateral lungs, which can be rapidly assessed by providers with limited POCUS experience 34 . Several of the findings we observed have excellent interrater reliability and can be expediently learned 28,35,36 . In contrast to more complex protocols, the results of this study suggest that a rapid assessment of the anterior lungs could provide meaningful risk stratification and warrants further investigation.…”

Section: Discussionmentioning

confidence: 63%

Point‐of‐CareUltrasound Predicts Clinical Outcomes in Patients WithCOVID‐19

Kumar

Weng

Graglia

et al. 2021

J of Ultrasound Medicine

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Objectives-Point-of-care ultrasound (POCUS) detects the pulmonary manifestations of COVID-19 and may predict patient outcomes.Methods-We conducted a prospective cohort study at four hospitals from March 2020 to January 2021 to evaluate lung POCUS and clinical outcomes of COVID-19. Inclusion criteria included adult patients hospitalized for COVID-19 who received lung POCUS with a 12-zone protocol. Each image was interpreted by two reviewers blinded to clinical outcomes. Our primary outcome was the need for intensive care unit (ICU) admission versus no ICU admission. Secondary outcomes included intubation and supplemental oxygen usage.Results-N = 160 patients were included. Among critically ill patients, B-lines (94 vs 76%; P < .01) and consolidations (70 vs 46%; P < .01) were more common. For scans collected within 24 hours of admission (N = 101 patients), early B-lines (odds ratio [OR] 4.41 [95% confidence interval, CI: 1.71-14.30]; P < .01) or consolidations (OR 2.49 [95% CI: 1.35-4.86]; P < .01) were predictive of ICU admission. Early consolidations were associated with oxygen usage after discharge (OR 2.16 [95% CI: 1.01-4.70]; P = .047). Patients with a normal scan within 24 hours of admission were less likely to require ICU admission (OR 0.28 [95% CI: 0.09-0.75]; P < .01) or supplemental oxygen (OR 0.26 [95% CI: 0.11-0.61]; P < .01). Ultrasound findings did not dynamically change over a 28-day scanning window after symptom onset.Conclusions-Lung POCUS findings detected within 24 hours of admission may provide expedient risk stratification for important COVID-19 clinical outcomes, including future ICU admission or need for supplemental oxygen. Conversely, a normal scan within 24 hours of admission appears protective. POCUS findings appeared stable over a 28-day scanning window, suggesting that these findings, regardless of their timing, may have clinical implications.

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Accuracy of Resident‐Performed Point‐of‐Care Lung Ultrasound Examinations Versus Chest Radiography in Pneumothorax Follow‐up After Tube Thoracostomy in Rwanda

Cited by 11 publications

References 27 publications

Point-of-Care Ultrasound (POCUS) Predicts Clinical Outcomes in Patients with COVID-19

Point-of-Care Ultrasound (POCUS) Predicts Clinical Outcomes in Patients with COVID-19

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Point‐of‐CareUltrasound Predicts Clinical Outcomes in Patients WithCOVID‐19

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