ASE Statement on Point-of-Care Ultrasound during the 2019 Novel Coronavirus Pandemic

Johri, Amer M.; Galen, Benjamin T.; Kirkpatrick, James N.; Lanspa, Michael J.; Mulvagh, Sharon L.; Thamman, Ritu

doi:10.1016/j.echo.2020.04.017

Cited by 129 publications

(153 citation statements)

References 4 publications

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“…The concern for nosocomial spread of the virus among healthcare workers and other hospitalized patients has led many societies and medical centers to recommend appropriately limiting exposure and imaging. 1,2 Point-of-care ultrasound is increasingly being used to diagnose, monitor, and manage patients in emergency departments and in those admitted to inpatient services. In patients with COVID-19 infection it is an excellent tool for comprehensive examination given that ultrasound is already commonly used in patient care, handheld ultrasound devices are easy to clean, and the nature of the virus is critical and dynamic.…”

Section: ■ Backgroundmentioning

confidence: 99%

Point-of-care ultrasound and COVID-19

Fox

Dugar

2020

CCJM

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Section: ■ Backgroundmentioning

confidence: 99%

Point-of-care ultrasound and COVID-19

Fox

Dugar

2020

CCJM

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“…However, prior research has demonstrated heterogeneous results. [1][2][3] Right ventricular dilatation and dysfunction, pulmonary hypertension, Takotsubo syndrome, global hypokinesis, normal left ventricular (LV) size, and hyperdynamic LV function were some of the most frequently reported echocardiographic findings. 4,5 Lung ultrasound (LUS) helps in the bedside detection of pulmonary pathologies, monitor the progression of mechanical ventilation, and detect complications such as pleural effusion, pneumothorax, and atelectasis.…”

Section: Introductionmentioning

confidence: 99%

Critical care ultrasonography during COVID‐19 pandemic: The ORACLE protocol

et al. 2020

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Background Coronavirus disease 2019 (COVID‐19) is characterized by severe lung involvement and hemodynamic alterations. Critical care ultrasonography is vital because it provides real time information for diagnosis and treatment. Suggested protocols for image acquisition and measurements have not yet been evaluated. Methods This cross‐sectional study was conducted at two centers from 1 April 2020 to 30 May 2020 in adult patients with confirmed COVID‐19 infection admitted to the critical care unit. Cardiac and pulmonary evaluations were performed using the ORACLE protocol, specifically designed for this study, to ensure a structured process of image acquisition and limit staff exposure to the infection. Results Eighty‐two consecutively admitted patients were evaluated. Most of the patients were males, with a median age of 56 years, and the most frequent comorbidities were hypertension and type 2 diabetes, and 25% of the patients had severe acute respiratory distress syndrome. The most frequent ultrasonographic findings were elevated pulmonary artery systolic pressure (69.5%), E/e’ ratio > 14 (29.3%), and right ventricular dilatation (28%) and dysfunction (26.8%). A high rate of fluid responsiveness (82.9%) was observed. The median score (19 points) on pulmonary ultrasound did not reveal any variation between the groups. Elevated pulmonary artery systolic pressure was associated with higher in‐hospital mortality. Conclusion The ORACLE protocol was a feasible, rapid, and safe bedside tool for hemodynamic and respiratory evaluation of patients with COVID‐19. Further studies should be performed on the alteration in pulmonary hemodynamics and right ventricular function and its relationship with outcomes.

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“…Estimation of pulmonary artery systolic pressure from tricuspid systolic gradient and a usually increased inferior vena cava diameter combined with a short acceleration time and midsystolic notch in the PW Doppler of the RVOT(‘60/60; sign) ( 26 ) further indicates increased PA pressure and proximal thromboemboli ( 27 ). In clinical practice, hemodynamic instability should lead to a cardiac Point of care Ultrasound (POCUS) ( 28 , 29 ) to determine the presence of left ventricular dysfunction and/or right ventricular dilatation or a large pericardial effusion ( Figure 1 ). Handheld echo devices are the most suitable for this indication as they are portable, more easily disinfected compared to traditional ultrasound machines, while images can be stored and transferred to a PC.…”

Section: Echocardiography For the Diagnosis Of Acute Cardiovascular Cmentioning

confidence: 99%

The Dual Role of Echocardiography in the Diagnosis of Acute Cardiac Complications and Treatment Monitoring for Coronavirus Disease 2019 (COVID-19)

Vrettou

Parissis

Ikonomidis

2020

Front. Cardiovasc. Med.

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The Coronavirus Disease 2019 (COVID-19) pandemic, being caused by an easily and rapidly spreading novel betacoronavirus, has created a state of emergency for people, the scientific community, healthcare systems and states, while the global financial consequences are still unfolding. Cardiovascular complications have been reported for COVID-19-infected patients and are associated with a worse prognosis. ECG and biomarkers may raise suspicion of cardiac involvement. However, transthoracic echocardiography is a fast and reliable bedside method to establish the diagnosis of cardiac complications, including acute coronary syndromes, pericarditis, myocarditis, and pulmonary embolism. Early detection of cardiac dysfunction by speckle tracking echocardiography during off-line analysis may be used to identify a high-risk population for development of heart failure in the acute setting. Precautionary measures are mandatory for operators and equipment to avoid viral dispersion. No specific treatment is yet available for severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2), and a variety of antiviral, immune-modifying, and antioxidant agents are therefore under intense investigation. Echocardiography, including assessment of myocardial deformation, may provide a useful tool to monitor the effects of the various treatment regimens on cardiac function both acutely and in the midterm.

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ASE Statement on Point-of-Care Ultrasound during the 2019 Novel Coronavirus Pandemic

Cited by 129 publications

References 4 publications

Point-of-care ultrasound and COVID-19

Point-of-care ultrasound and COVID-19

Critical care ultrasonography during COVID‐19 pandemic: The ORACLE protocol

The Dual Role of Echocardiography in the Diagnosis of Acute Cardiac Complications and Treatment Monitoring for Coronavirus Disease 2019 (COVID-19)

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