Lung Ultrasound as a Promising Diagnostic Tool for Primary Graft Dysfunction after Lung Transplantation

Abstract

Purpose The aim of the study was to evaluate whether the quantification of B-lines via lung ultrasound after lung transplantation is feasible and correlates with the diagnosis of primary graft dysfunction. Methods Following lung transplantation, patients underwent daily lung ultrasound on postoperative days 1–3. B-lines were quantified by an ultrasound score based on the number of single and confluent B-lines per intercostal space, using a four-region protocol. The ultrasound score was correlated with the diagnosis of primary graft dysfunction. Furthermore, correlation analyses and receiver operating characteristics analyses taking into account ultrasound score, chest radiographs, and PaO2/FiO2 ratio were performed. Results A total of 32 patients (91 ultrasound measurements) were included, whereby 10 were diagnosed with primary graft dysfunction. The median B-line score was 5 [IQR: 4, 8]. There was a significant correlation between B-line score and the diagnosis of primary graft dysfunction (r = 0.59, p < 0.001). A significant correlation could also be seen between chest X-rays and primary graft dysfunction (r = 0.34, p = 0.008), but the B-line score showed superiority over chest X-rays with respect to diagnosing primary graft dysfunction in the receiver operating characteristics curves with an area under the curve value of 0.921 versus 0.708. There was a significant negative correlation between B-line score and PaO2/FiO2 ratio (r = –0.41, p < 0.001), but not between chest X-rays and PaO2/FiO2 ratio (r = –0.14, p = 0.279). Conclusion The appearance of B-lines correlated well with primary graft dysfunction and outperformed chest radiographs.

Lung Ultrasound and Pleural Artifacts: A Pictorial Review

“…However, initial data indicated a notable correlation between the B-line score and the identification of primary graft dysfunction in patients following lung transplantation. LUS was more effective than chest X-rays, suggesting that LUS could be a valuable tool for diagnosing primary graft dysfunction in post-lung-transplant patients [49]. Furthermore, at present, terms such as "B-lines" and "CTAs" are used heterogeneously and sometimes synonymously in the literature.…”

Effects of robotic-assisted early mobilization versus conventional mobilization in intensive care unit patients: prospective interventional cohort study with retrospective control group analysis

“…Eligible patients were adults (> 18 years) scheduled for elective surgery with an expected ventilation duration of > 48 h. We excluded patients not capable of consent, chronically bedridden patients, patients with preoperative ventilation, and patients with preexisting neuromuscular disease that impaired strength. A control group was retrospectively selected from adults that had undergone elective surgery between May and August 2021, met the same inclusion and exclusion criteria as the intervention group, and had received ultrasound measurements routinely or as part of another observational study [ 11 ]. No matching was performed.…”

Effects of robotic-assisted early mobilization versus conventional mobilization in intensive care unit patients: The MobiStaR trial

“…A control group was retrospectively selected from adults that had undergone elective surgery between May and August 2021, which one would expect to lead to postoperative ventilation of > 48 h, and had received ultrasound measurements routinely or as part of another observational study [22]. Exclusion criteria were the same as those for the intervention group.…”