Lung Ultrasound: The Emerging Role of Respiratory Therapists

Karthika, M; Wong, Duane; Nair, Suresh; Pillai, Lalitha V.; Mathew, Chris Sara

doi:10.4187/respcare.06179

Cited by 20 publications

(14 citation statements)

References 101 publications

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“…Nurses and respiratory therapists can also be easily trained to perform focused ultrasound assessments. 5,6 During the current pandemic, disease containment and provider safety are high priorities. We must embrace emerging technologies such as handheld ultrasound devices to allow us to achieve these aims while providing high quality care to our patients.…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

Handheld ultrasound devices: An emerging technology to reduce viral spread during the Covid-19 pandemic

Gibson

Bittner

Chang

2020

American Journal of Infection Control

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Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

Handheld ultrasound devices: An emerging technology to reduce viral spread during the Covid-19 pandemic

Gibson

Bittner

Chang

2020

American Journal of Infection Control

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“…In the last decades, LUS has proven to be a suitable alternative to conventional radiological methods in multiple kinds of lung diseases (24)(25)(26)(27). During the current pandemic, numerous studies have reported the usefulness of LUS as a front-line tool in the diagnosis and management of SARS-CoV-2 acute pneumonia (28)(29)(30)(31).…”

Section: Introductionmentioning

confidence: 99%

Lung Ultrasound as a First-Line Test in the Evaluation of Post-COVID-19 Pulmonary Sequelae

et al. 2022

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Background: Interstitial lung sequelae are increasingly being reported in survivors of COVID-19 pneumonia. An early detection of these lesions may help prevent the development of irreversible lung fibrosis. Lung ultrasound (LUS) has shown high diagnostic accuracy in interstitial lung disease (ILD) and could likely be used as a first-line test for post-COVID-19 lung sequelae.Methods: Single-center observational prospective study. Follow-up assessments of consecutive patients hospitalized for COVID-19 pneumonia were conducted 2–5 months after the hospitalization. All patients underwent pulmonary function tests (PFTs), high-resolution computed tomography (HRCT), and LUS. Radiological alterations in HRCT were quantified using the Warrick score. The LUS score was obtained by evaluating the presence of pathological B-lines in 12 thoracic areas (range, 0–12). The correlation between the LUS and Warrick scores was analyzed.Results: Three hundred and fifty-two patients who recovered from COVID-19 pneumonia were recruited between July and September 2020. At follow-up, dyspnea was the most frequent symptom (69.3%). FVC and DLCO alterations were present in 79 (22.4%) and 234 (66.5%) patients, respectively. HRCT showed relevant interstitial lung sequelae (RILS) in 154 (43.8%) patients (Warrick score ≥ 7). The LUS score was strongly correlated with the HRCT Warrick score (r = 0.77) and showed a moderate inverse correlation with DLCO (r = −0.55). The ROC curve analysis revealed that a LUS score ≥ 3 indicated an excellent ability to discriminate patients with RILS (sensitivity, 94.2%; specificity, 81.8%; negative predictive value, 94.7%).Conclusions: LUS could be implemented as a first-line procedure in the evaluation of Post-COVID-19 interstitial lung sequelae. A normal LUS examination rules out the presence of these sequelae in COVID-19 survivors, avoiding the need for additional diagnostic tests such as HRCT.

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“…For example, the focus in thoracic US has been to develop practice-based evidence, prior to the advancement of psychometric data. This has led to enthusiastic adoption of US into critical care and respiratory physiotherapy services [ 75 – 77 ]; however, the lack of formal research evidence is now considered a barrier to implementation and acceptance of US for this purpose [ 29 ]. There is an opportunity to avoid this conflict by implementing swallowing and laryngeal US into clinical practice in a systematic and evidence-based way, using lessons learned from other professional groups and previous implementation of assessment tools in the SLP profession.…”

Section: Discussionmentioning

confidence: 99%

Translating Ultrasound into Clinical Practice for the Assessment of Swallowing and Laryngeal Function: A Speech and Language Pathology-Led Consensus Study

et al. 2022

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Ultrasound (US) has an emerging evidence base for the assessment of swallowing and laryngeal function. Accessibility and technological advances support the use of US as a clinical assessment tool; however, there is insufficient evidence to support its translation into clinical practice. This study aimed to establish consensus on the priorities for translation of US into clinical practice for the assessment of swallowing and laryngeal function. Nominal Group Technique (NGT) was used as a formal method of consensus development. Clinicians and academics, all members of an international US working group, were invited to participate in the study. Two NGT meetings were held, where participants silently generated and then shared ideas. Participants anonymously ranked items. Rankings were aggregated before participants re-ranked items in order of priority. Discussions regarding rankings were recorded and transcribed to inform analysis. Member-checking with participants informed the final analysis. Participants (n = 15) were speech and language pathologists, physiotherapists and sonographers representing six countries. Fifteen items were identified and prioritised 1–13 (including two equally ranked items). Reliability, validity and normative data emerged as key areas for research while development of training protocols and engagement with stakeholders were considered vital to progressing US into practice. Analysis revealed common themes that might be addressed together in research, in addition to the ranked priority. A measured approach to the translation of US into clinical practice will enable effective implementation of this tool. Priorities may evolve as clinical and professional contexts shift, but this study provides a framework to advance research and clinical practice in this field.

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Lung Ultrasound: The Emerging Role of Respiratory Therapists

Cited by 20 publications

References 101 publications

Handheld ultrasound devices: An emerging technology to reduce viral spread during the Covid-19 pandemic

Handheld ultrasound devices: An emerging technology to reduce viral spread during the Covid-19 pandemic

Lung Ultrasound as a First-Line Test in the Evaluation of Post-COVID-19 Pulmonary Sequelae

Translating Ultrasound into Clinical Practice for the Assessment of Swallowing and Laryngeal Function: A Speech and Language Pathology-Led Consensus Study

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