Lung ultrasound and supine chest X-ray use in modern adult intensive care: mapping 30 years of advancement (1993–2023)

Vetrugno, Luigi; Biasucci, Daniele Guerino; Deana, Cristian; Spadaro, Savino; Lombardi, Fiorella Anna; Longhini, Federico; Pisani, Luigi; Boero, Enrico; Cereser, Lorenzo; Cammarota, Gianmaria; Maggiore, Salvatore Maurizio

doi:10.1186/s13089-023-00351-4

Cited by 3 publications

References 111 publications

(98 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

Lung ultrasound among Expert operator’S: ScOring and iNter-rater reliability analysis (LESSON study) a secondary COWS study analysis from ITALUS group

Boero,

Gargani,

Schreiber

et al. 2024

J Anesth Analg Crit Care

View full text Add to dashboard Cite

Background Lung ultrasonography (LUS) is a non-invasive imaging method used to diagnose and monitor conditions such as pulmonary edema, pneumonia, and pneumothorax. It is precious where other imaging techniques like CT scan or chest X-rays are of limited access, especially in low- and middle-income countries with reduced resources. Furthermore, LUS reduces radiation exposure and its related blood cancer adverse events, which is particularly relevant in children and young subjects. The score obtained with LUS allows semi-quantification of regional loss of aeration, and it can provide a valuable and reliable assessment of the severity of most respiratory diseases. However, inter-observer reliability of the score has never been systematically assessed. This study aims to assess experienced LUS operators’ agreement on a sample of video clips showing predefined findings. Methods Twenty-five anonymized video clips comprehensively depicting the different values of LUS score were shown to renowned LUS experts blinded to patients’ clinical data and the study’s aims using an online form. Clips were acquired from five different ultrasound machines. Fleiss-Cohen weighted kappa was used to evaluate experts’ agreement. Results Over a period of 3 months, 20 experienced operators completed the assessment. Most worked in the ICU (10), ED (6), HDU (2), cardiology ward (1), or obstetric/gynecology department (1). The proportional LUS score mean was 15.3 (SD 1.6). Inter-rater agreement varied: 6 clips had full agreement, 3 had 19 out of 20 raters agreeing, and 3 had 18 agreeing, while the remaining 13 had 17 or fewer people agreeing on the assigned score. Scores 0 and score 3 were more reproducible than scores 1 and 2. Fleiss’ Kappa for overall answers was 0.87 (95% CI 0.815–0.931, p < 0.001). Conclusions The inter-rater agreement between experienced LUS operators is very high, although not perfect. The strong agreement and the small variance enable us to say that a 20% tolerance around a measured value of a LUS score is a reliable estimate of the patient's true LUS score, resulting in reduced variability in score interpretation and greater confidence in its clinical use.

show abstract

Lung ultrasound among Expert operator’S: ScOring and iNter-rater reliability analysis (LESSON study) a secondary COWS study analysis from ITALUS group

Boero,

Gargani,

Schreiber

et al. 2024

J Anesth Analg Crit Care

View full text Add to dashboard Cite

show abstract

The Clinical Value of Non-invasive Lung Ultrasound in Assessing Pediatric Mycoplasma Pneumoniae Pneumonia

Zhang,

Ye,

et al. 2024

Preprint

View full text Add to dashboard Cite

Objective To investigate the clinical value of bedside lung ultrasound (LUS) in the non-invasive assessment of lung lesions in children with Mycoplasma pneumoniae pneumonia (MPP). Methods A total of 47 children with MPP hospitalized at our hospital from October 1, 2023 to December 31, 2023 were included. All children underwent LUS and chest CT examinations. The sonographic patterns of lung lesions were observed and scored using LUS, and the results were compared with chest CT as the “gold standard” to evaluate the comparability of LUS and chest CT in the diagnosis of pediatric MPP. Results The main LUS findings in children with MPP were interstitial edema (87.2%, 41/47) and lung consolidation (55.3%, 26/47), with bilateral involvement predominantly affecting the basal and dorsal regions of the lung. There was a moderate agreement between bedside LUS and chest CT in assessing lung lesions in children with MPP (Kappa = 0.609). The positive rate of MPP detected by LUS was 87.2% (41/47), and LUS’ accuracy in diagnosing MPP was 74.4% (35/47). In evaluating mild, moderate, and severe MPP, the sensitivity of LUS was 73.3%, 70.6%, and 72.7%; the specificity was 84.3%, 84.3%, and 100.0%; and the accuracy was 80.9%, 85.1%, and 93.6%, respectively. Conclusion LUS demonstrates a good performance in the assessment of lung lesions in children with MPP, and is worthy of further clinical promotion.

show abstract

Advanced Respiratory Monitoring during Extracorporeal Membrane Oxygenation

Simonte,

Cammarota,

Vetrugno

et al. 2024

JCM

Self Cite

View full text Add to dashboard Cite

Advanced respiratory monitoring encompasses a diverse range of mini- or noninvasive tools used to evaluate various aspects of respiratory function in patients experiencing acute respiratory failure, including those requiring extracorporeal membrane oxygenation (ECMO) support. Among these techniques, key modalities include esophageal pressure measurement (including derived pressures), lung and respiratory muscle ultrasounds, electrical impedance tomography, the monitoring of diaphragm electrical activity, and assessment of flow index. These tools play a critical role in assessing essential parameters such as lung recruitment and overdistention, lung aeration and morphology, ventilation/perfusion distribution, inspiratory effort, respiratory drive, respiratory muscle contraction, and patient–ventilator synchrony. In contrast to conventional methods, advanced respiratory monitoring offers a deeper understanding of pathological changes in lung aeration caused by underlying diseases. Moreover, it allows for meticulous tracking of responses to therapeutic interventions, aiding in the development of personalized respiratory support strategies aimed at preserving lung function and respiratory muscle integrity. The integration of advanced respiratory monitoring represents a significant advancement in the clinical management of acute respiratory failure. It serves as a cornerstone in scenarios where treatment strategies rely on tailored approaches, empowering clinicians to make informed decisions about intervention selection and adjustment. By enabling real-time assessment and modification of respiratory support, advanced monitoring not only optimizes care for patients with acute respiratory distress syndrome but also contributes to improved outcomes and enhanced patient safety.

show abstract

Lung ultrasound and supine chest X-ray use in modern adult intensive care: mapping 30 years of advancement (1993–2023)

Cited by 3 publications

References 111 publications

Lung ultrasound among Expert operator’S: ScOring and iNter-rater reliability analysis (LESSON study) a secondary COWS study analysis from ITALUS group

Lung ultrasound among Expert operator’S: ScOring and iNter-rater reliability analysis (LESSON study) a secondary COWS study analysis from ITALUS group

The Clinical Value of Non-invasive Lung Ultrasound in Assessing Pediatric Mycoplasma Pneumoniae Pneumonia

Advanced Respiratory Monitoring during Extracorporeal Membrane Oxygenation

Contact Info

Product

Resources

About