Consensus of the Study Group for Point-of-Care Lung Ultrasound in the intensive care management of COVID-19 patients

Buda, Natalia; Andruszkiewicz, Paweł; Czuczwar, Mirosław; Gola, Wojciech; Kosiak, Wojciech; Nowakowski, Piotr; Sporysz, Krystian

doi:10.5114/ait.2020.96560

Cited by 6 publications

(11 citation statements)

References 44 publications

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“…In our study, we based our score on the progressive loss of aeration described in pneumonia [ 20 , 39 , 48 ]. However, we discriminated between subpleural and lobar consolidations as the most relevant finding [ 10 , 38 , 43 ] due to their contribution to uneven alveolar ventilation–perfusion [ 8 , 25 , 27 ]. Our data showed that LUS scores obtained at D1 predicted the P/F ratio when using comprehensive cohort data.…”

Section: Discussionmentioning

confidence: 99%

Time course of lung ultrasound findings in patients with COVID-19 pneumonia and cardiac dysfunction

et al. 2022

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Background Lung ultrasound (LUS) is a valuable tool to predict and monitor the COVID-19 pneumonia course. However, the influence of cardiac dysfunction (CD) on LUS findings remains to be studied. Our objective was to determine the effect of CD on LUS in hospitalized patients with COVID-19 pneumonia. Material and methods Fifty-one patients with COVID-19 pneumonia participated in the study. Focused echocardiography (FoCUS) was carried out on day 1 to separate patients into two groups depending on whether they had FoCUS signs of CD (CD+ vs CD−). LUS scores, based on the thickness of the pleural line, the B-line characteristics, and the presence or not of consolidations, were obtained three times along the patient’s admission (D1, D5, D10) and compared between CD+ and CD− patients. A correlation analysis was carried out between LUS scores and the ratio of the arterial partial pressure of oxygen to the fraction of the inspired oxygen (P/F ratio). Results Twenty-two patients were CD+ and 29 patients were CD−. Among the CD+ patients, 19 were admitted to the intensive care unit (ICU), seven received invasive mechanical ventilation (IMV), and one did not survive. Among the CD− patients, 11 were admitted to the ICU, one received IMV and seven did not survive. CD+ patients showed a significantly lower P/F ratio than CD− patients. However, LUS scores showed no between-group differences, except for fewer subpleural consolidations in the upper quadrants of CD+ than on CD− patients. Conclusion In patients with COVID-19, CD contributed to a worse clinical course, but it did not induce significant changes in LUS. Our findings suggest that pathophysiological factors other than those reflected by LUS may be responsible for the differences in clinical condition between CD+ and CD− patients.

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Section: Discussionmentioning

confidence: 99%

Time course of lung ultrasound findings in patients with COVID-19 pneumonia and cardiac dysfunction

et al. 2022

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“…B-line artifacts are significant in diagnosing many diseases that affect the pulmonary interstitial space and alveoli [1,6]. These artifacts are defined as laser-like vertical re-verberation artifacts arising from the pleural line, extending to the bottom of the screen (irrespective of the set depth), moving along with the lung slide, and leading to the disappearance of A-lines [7].…”

Section: Introductionmentioning

confidence: 99%

Clinical Impact of Vertical Artifacts Changing with Frequency in Lung Ultrasound

et al. 2021

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Background: This study concerns the application of lung ultrasound (LUS) for the evaluation of the significance of vertical artifact changes with frequency and pleural line abnormalities in differentiating pulmonary edema from pulmonary fibrosis. Study Design and Methods: The study was designed as a diagnostic test. Having qualified patients for the study, an ultrasound examination was performed, consistent with a predetermined protocol, and employing convex and linear transducers. We investigated the possibility of B-line artifact conversion depending on the set frequency (2 MHz and 6 MHz), and examined pleural line abnormalities. Results: The study group comprised 32 patients with interstitial lung disease (ILD) (and fibrosis) and 30 patients with pulmonary edema. In total, 1941 cineloops were obtained from both groups and analyzed. The employment of both types of transducers (linear and convex) was most effective (specificity 91%, specificity 97%, positive predictive value (PPV) 97%, negative predictive value (NPV) 91%, LR(+) 27,19, LR(−) 0.097, area under curve (AUC) = 0.936, p = 7 × 10−6). Interpretation: The best accuracy in differentiating the etiology of B-line artifacts was obtained with the use of both types of transducers (linear and convex), complemented with the observation of the conversion of B-line artifacts to Z-line.

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“…This form of education may be successfully applied in the teaching and learning of lung ultrasound techniques. 54 Moreover, Pivetta et al reported that a patient self-performed lung ultrasound in the home with a hand-held device under the guidance of a physician using a novel teleguidance platform is also possible. Maximum isolation, thus, can be obtained.…”

Section: Of Lus In Covid-19 Pneumoniamentioning

confidence: 99%

The role of lung ultrasonography in evaluation of COVID-19 pneumonia

2021

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After a few months it emerged in Wuhan (China), Coronavirus Disease 2019 (COVID-19) caused by 2019 novel coronavirus (2019-nCoV) was declared as a pandemic by the World Health Organization (WHO). Diagnosis of the disease is mainly based on real time polymerase chain reaction (PCR) test by nasopharyngeal swab. However, due to excess of numbers of false-negative PCR test results, chest computed tomography (CT) is commonly used as a supplementary modality. However, CT has some disadvantages. Firstly, a normal chest CT scan does not exclude the diagnosis of COVID-19 pneumonia. Additionally, the radiation exposure and a weak diagnostic value are other challenges. When the infection is limited to upper respiratory system or performed in the early stage, false-negative results may be obtained on CT scan. Recently lung ultrasonography (LUS) has emerged as a easy-to-use, cost-effective and radiation-free tool in diagnosis, management and follow-up of COVID-19 pneumonia. In this narrative review, our aim is to clarify the utility of LUS in COVID-19 pneumonia with its advantages and disadvantages. We also aimed to guide clinicians to use LUS as a practical tool.

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Consensus of the Study Group for Point-of-Care Lung Ultrasound in the intensive care management of COVID-19 patients

Cited by 6 publications

References 44 publications

Time course of lung ultrasound findings in patients with COVID-19 pneumonia and cardiac dysfunction

Time course of lung ultrasound findings in patients with COVID-19 pneumonia and cardiac dysfunction

Clinical Impact of Vertical Artifacts Changing with Frequency in Lung Ultrasound

The role of lung ultrasonography in evaluation of COVID-19 pneumonia

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