Recommendations for Lung Ultrasound in Internal Medicine

Buda, Natalia; Kosiak, Wojciech; Wełnicki, Marcin; Skoczylas, Agnieszka; Olszewski, Robert; Piotrkowski, Jakub; Skoczyński, Szymon; Radzikowska, Elżbieta; Jassem, Ewa; Grabczak, Elżbieta M.; Kwaśniewicz, Piotr; Mathis, Gebhard; Toma, Tudor

doi:10.3390/diagnostics10080597

Cited by 45 publications

(56 citation statements)

References 177 publications

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“…In emergency medicine, sonographers are equipped with standardised LUS protocols enabling rapid patient assessment [ 7 , 8 ]. For adult patients, both Polish recommendations on LUS application in internal medicine [ 9 , 10 ], and international evidence-based recommendations on the point of care lung ultrasound are followed. Few recommendations regarding the use of LUS in neonatal and paediatric diseases are outlined in the latter [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Consensus on the Application of Lung Ultrasound in Pneumonia and Bronchiolitis in Children

Jaworska¹,

Komorowska-Piotrowska

Pomiećko

et al. 2020

Diagnostics

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This evidence-based consensus aims to establish the role of point-of-care lung ultrasound in the management of pneumonia and bronchiolitis in paediatric patients. A panel of thirteen experts form five Polish tertiary pediatric centres was involved in the development of this document. The literature search was done in PubMed database. Statements were established based on a review of full-text articles published in English up to December 2019. The development of this consensus was conducted according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluations)—adopted and Delphi method. Initially, 22 proposed statements were debated over 3 rounds of on-line discussion and anonymous voting sessions. A total of 17 statements were agreed upon, including four statements referring to general issues, nine referring to pneumonia and four to bronchiolitis. For five statements experts did not achieve an agreement. The evidence supporting each statement was evaluated to assess the strength of each statement. Overall, eight statements were rated strong, five statements moderate, and four statements weak. For each statement, experts provided their comments based on the literature review and their own experience. This consensus is the first to establish the role of lung ultrasound in the diagnosis and management of pneumonia and bronchiolitis in children as an evidence-based method of imaging.

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Section: Introductionmentioning

confidence: 99%

Consensus on the Application of Lung Ultrasound in Pneumonia and Bronchiolitis in Children

Jaworska¹,

Komorowska-Piotrowska

Pomiećko

et al. 2020

Diagnostics

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“…The next stage is the appearance of subpleural consolidations with a static air bronchogram or without bronchogram, with frequent B-lines coexisting marginally. When the aeration of pulmonary alveoli improves, the changes are observed in the reverse order: the initial subpleural consolidations will turn into B-line artifacts, and with further improvement—it is possible to obtain the normal lung image, i.e., A-line artifacts [ 31 , 32 , 33 , 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Lung Ultrasonography in the Monitoring of Intraoperative Recruitment Maneuvers

Cylwik¹,

Buda

2021

Diagnostics

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Introduction: Postoperative respiratory failure is a serious problem in patients who undergo general anesthesia. Approximately 90% of mechanically ventilated patients during the surgery may develop atelectasis that leads to perioperative complications. Aim: The aim of this study is to determine whether it is possible to optimize recruitment maneuvers with the use of chest ultrasonography, thus limiting the risk of respiratory complications in patients who undergo general anesthesia. Methodology: The method of incremental increases in positive end-expiratory pressure (PEEP) values with simultaneous continuous ultrasound assessments was employed in mechanically ventilated patients. Results: The study group comprised 100 patients. The employed method allowed for atelectasis reduction in 91.9% of patients. The PEEP necessary to reverse areas of atelectasis averaged 17cmH2O, with an average peak pressure of 29cmH2O. The average PEEP that prevented repeat atelectasis was 9cmH2O. A significant improvement in lung compliance and saturation was obtained. Conclusions: Ultrasound-guided recruitment maneuvers facilitate the patient-based adjustment of the process. Consequently, the reduction in ventilation pressures necessary to aerate intraoperative atelectasis is possible, with the simultaneous reduction in the risk of procedure-related complications.

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“…Consolidations were defined as subpleural large hypoechoic or liver-like areas interrupting the overlying pleural line echogenicity and characteristically showing blurred deep margins [ 21 ]. Subpleural nodules were defined as subpleural hypoechoic small lesions (<3 mm), round or oval in shape, interrupting the hyperechoic pleural line [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

Low Sensitivity of Admission Lung US Compared to Chest CT for Diagnosis of Lung Involvement in a Cohort of 82 Patients with COVID-19 Pneumonia

et al. 2021

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Background and Objectives: The potential role of lung ultrasound (LUS) in characterizing lung involvement in Coronavirus disease 2019 (COVID-19) is still debated. The aim of the study was to estimate sensitivity of admission LUS for the detection of SARS-CoV-2 lung involvement using Chest-CT (Computed Tomography) as reference standard in order to assess LUS usefulness in ruling out COVID-19 pneumonia in the Emergency Department (ED). Methods: Eighty-two patients with confirmed COVID-19 and signs of lung involvement on Chest-CT were consecutively admitted to our hospital and recruited in the study. Chest-CT and LUS examination were concurrently performed within the first 6–12h from admission. Sensitivity of LUS was calculated using CT findings as a reference standard. Results: Global LUS sensitivity in detecting COVID-19 pulmonary lesions was 52%. LUS sensitivity ranged from 8% in case of focal and sporadic ground-glass opacities (mild disease), to 52% for a crazy-paving pattern (moderate disease) and up to 100% in case of extensive subpleural consolidations (severe disease), although LUS was not always able to detect all the consolidations assessed at Chest-CT. LUS sensitivity was higher in detecting a typical Chest-CT pattern (60%) and abnormalities showing a middle-lower zone predominance (79%). Conclusions: As admission LUS may result falsely negative in most cases, it should not be considered as a reliable imaging tool in ruling out COVID-19 pneumonia in patients presenting in ED. It may at least represent an expanded clinical evaluation that needs integration with other diagnostic tests (e.g., nasopharyngeal swab, Chest-CT).

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Recommendations for Lung Ultrasound in Internal Medicine

Cited by 45 publications

References 177 publications

Consensus on the Application of Lung Ultrasound in Pneumonia and Bronchiolitis in Children

Consensus on the Application of Lung Ultrasound in Pneumonia and Bronchiolitis in Children

Lung Ultrasonography in the Monitoring of Intraoperative Recruitment Maneuvers

Low Sensitivity of Admission Lung US Compared to Chest CT for Diagnosis of Lung Involvement in a Cohort of 82 Patients with COVID-19 Pneumonia

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