Lung ultrasound: a valuable tool for the assessment of dialysis patients with COVID-19

Reisinger, Nathaniel; Koratala, Abhilash

doi:10.1007/s10157-020-01903-x

Cited by 16 publications

(24 citation statements)

References 7 publications

(6 reference statements)

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“…Patients on hemodialysis are at increased risk of contagion and serious complications during the COVID-19 pandemic ( Alberici et al 2020 ), because of frequent contact with health care facilities and a high comorbidity burden. Although patients on dialysis have multiple potential etiologies for dyspnea and multiple B-lines at LUS (such as heart failure and fluid overload) and for fever (such as vascular access infection), different LUS patterns detected in COVID-19 patients may help in differential diagnosis in this setting ( Reisinger and Koratala 2020 ; Vieira et al 2020 ).…”

Section: Lus Can Guide Therapeutic Decisions and Procedures In Differmentioning

confidence: 99%

Lung Ultrasound May Support Diagnosis and Monitoring of COVID-19 Pneumonia

Allinovi

Parise

Giacalone

et al. 2020

Ultrasound in Medicine & Biology

110

125

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) is characterized by severe pneumonia and/or acute respiratory distress syndrome in about 20% of infected patients. Computed tomography (CT) is the routine imaging technique for diagnosis and monitoring of COVID-19 pneumonia. Chest CT has high sensitivity for diagnosis of COVID-19, but is not universally available, requires an infected or unstable patient to be moved to the radiology unit with potential exposure of several people, necessitates proper sanification of the CT room after use and is underutilized in children and pregnant women because of concerns over radiation exposure. The increasing frequency of confirmed COVID-19 cases is striking, and new sensitive diagnostic tools are needed to guide clinical practice. Lung ultrasound (LUS) is an emerging non-invasive bedside technique that is used to diagnose interstitial lung syndrome through evaluation and quantitation of the number of B-lines, pleural irregularities and nodules or consolidations. In patients with COVID-19 pneumonia, LUS reveals a typical pattern of diffuse interstitial lung syndrome, characterized by multiple or confluent bilateral B-lines with spared areas, thickening of the pleural line with pleural line irregularity and peripheral consolidations. LUS has been found to be a promising tool for the diagnosis of COVID-19 pneumonia, and LUS findings correlate fairly with those of chest CT scan. Compared with CT, LUS has several other advantages, such as lack of exposure to radiation, bedside repeatability during follow-up, low cost and easier application in low-resource settings. Consequently, LUS may decrease utilization of conventional diagnostic imaging resources (CT scan and chest X-ray). LUS may help in early diagnosis, therapeutic decisions and follow-up monitoring of COVID-19 pneumonia, particularly in the critical care setting and in pregnant women, children and patients in areas with high rates of community transmission.

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Section: Lus Can Guide Therapeutic Decisions and Procedures In Differmentioning

confidence: 99%

Lung Ultrasound May Support Diagnosis and Monitoring of COVID-19 Pneumonia

Allinovi

Parise

Giacalone

et al. 2020

Ultrasound in Medicine & Biology

110

125

View full text Add to dashboard Cite

show abstract

“…Of 439 records screened, 405 were excluded by title and abstract screening. Of 34 full-text articles assessed for elegibility, 6 articles were excluded, and 28 articles were included in qualitative analysis ( Alkhafaji et al 2020 ; Bar et al 2020 ; Buonsenso et al 2020a ; Buonsenso et al 2020b ; Consoli et al 2020 ; Denina et al 2020 ; Duclos et al 2020 ; Farrow et al 2020 ; Feng et al 2020 ; Huang et al 2020 Inchingolo et al 2020 ; Ji et al 2020 ; Lomoro et al 2020 ; Lu et al 2020 ; Mongodi et al 2020 ; Musolino et al 2020 ; Nouvenne et al 2020 ; Palmese et al 2020 ; Peng et al 2020 ; Poggiali et al 2020 ; Reisinger and Koratala 2020 ; Shokoohi et al 2020 ; Thomas et al 2020 ; Tung-Chen 2020 ; Xing et al 2020 ; Yang et al 2020 ; Yassa et al 2020; Yasukawa and Minami 2020 ;) were included ( Figure 1 ) . The studies were classified as the following: 2 retrospective cohort studies that included 150 patients, 1 prospective cohort with 31 patients, a cross-sectional study with 26 patients, 14 case series that included between 3 and 30 patients, and 10 case reports.…”

Section: Resultsmentioning

confidence: 99%

Pulmonary Ultrasound in the Diagnosis and Monitoring of Coronavirus Disease (COVID-19): A Systematic Review

Pecho-Silva

Navarro-Solsol

Taype-Rondán

et al. 2021

Ultrasound in Medicine & Biology

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Systemize the evidence of pulmonary ultrasound (PU) use in diagnosis, monitorization or hospital discharge criteria for patients with COVID-19. Systematic review of evidence which utilized PU for diagnosis, monitorization, or as hospital discharge criteria for COVID-19 patients confirmed by RT-PCR between December 1st of 2019 and July 5th of 2020 compared with thoracic radiograph (TR), thoracic tomography (CT) and RT-PCR. Type of study, motives for PU, population, type of transducer and protocol, results of PU, and quantitative or qualitative correlation with TR and/or CT and/or RT-PCR were evaluated. Were evaluated 28 articles with 418 patients. Average age 50 years (SD 25.1 years), 395 adults and 23 children. 143 were women, 13 pregnant women. The most frequent result was diffuse, coalescent and confluent B-lines. The plural line was irregular, interrupted, or thickened. The presence of subpleural consolidation was noduliform, lobar, or multilobar. There was good qualitative correlation between TR and CT and a quantitative correlation with CT of r=0.65 (p<0.001). 44 patients were evaluated only with PU. PU is a useful tool for diagnosis, monitorization, and criteria for hospital discharge for patients with COVID-19.

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“…The Japanese Society of Nephrology highlighted the utilization of lung ultrasound as a “valuable tool for the assessment of dialysis patients with COVID-19 [ 31 ].”They note that the detection of focal B-lines on ultrasound may be more sensitive and efficient than CT findings, especially in early disease. They proposed that outpatient dialysis facilities adopt lung ultrasound as a bedside tool to diagnose and monitor disease severity, while also differentiating COVID-19 from other possible causes of dyspnea.…”

Section: Resultsmentioning

confidence: 99%

“…Advantages of lung ultrasound are summarized in Table 3 . The society also highlighted that the greatest barrier to having lung ultrasound in outpatient facilities is that dialysis units lack trained staff for performing and interpreting the imaging studies [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

“…If the patient's nephrologist feels that the patient is clinically stable by assessing vital signs despite answering yes to one of the CDC's criteria, and have a portable ultrasound present in the facility, the nephrologist should consider looking for B-lines to evaluate fluid status before transferring the patient to the ED as recommended by the Japanese [ 31 ]. [Unfortunately, there is not always a nephrologist present in the dialysis unit, and dialysis unit nurses and other providers may not know how to diagnose and interpret ultrasound studies.]…”

Section: Discussionmentioning

confidence: 99%

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