Time to embrace POCUS as part of the bedside diagnosis of respiratory diseases

Porcel, José M.

doi:10.1111/resp.13692

Cited by 8 publications

(4 citation statements)

References 11 publications

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“…Ultrasound scoring method: According to the lung ultrasound (LUS) score [3], the following grading was used in each region: 0 points (pleural line and A-line, < 3 B lines); 1 point (more than 3 B-lines); 2 points (coalescent B-lines); 3 points (pulmonary consolidation signs). The LUS score was calculated as the sum of all regional scores ranging from 0-36 points.…”

Section: Image Analysismentioning

confidence: 99%

A Clinical Study of Noninvasive Assessment of Lung Lesions in Patients with Coronavirus Disease-19 (COVID-19) by Bedside Ultrasound

et al. 2020

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Purpose This study was conducted to explore the clinical value of noninvasive assessment of bedside ultrasound in the diagnosis of lung lesions of Coronavirus Disease-19. Methods In this retrospective study, 30 patients with Coronavirus Disease-19 admitted to our hospital from January 18 to February 5, 2020, were selected as the research subjects. All cases were examined by lung ultrasound and CT. Lung lesions were reviewed by blinded observers, with imaging scores being used to analyze the ultrasound findings of lung lesions in patients with Coronavirus Disease-19 and with chest CT being used as the reference standard. The clinical value of ultrasound in the noninvasive assessment of lung lesions was evaluated. Results Lung ultrasound signs in patients with Coronavirus Disease-19 were mainly manifested as interstitial pulmonary edema (90.0 %, 27/30) and pulmonary consolidations (20.0 %, 6/30). The lung lesions were mainly distributed in the subpleural and peripheral pulmonary zones. The lower lobe and the dorsal region had a greater tendency to be involved. There was moderate agreement (Kappa = 0.529) between the noninvasive assessment of bedside ultrasound for lung lesions in patients with Coronavirus Disease-19 and CT. The ultrasound scores to evaluate mild, moderate and severe lung lesions exhibited sensitivity of 68.8 % (11/16), 77.8 % (7/9), 100.0 % (2/2), specificity of 85.7 % (12/14), 76.2 % (16/21), 92.9 % (26/28), and diagnostic accuracy of 76.7 % (23/30), 76.7 % (23/30), 93.3 % (28/30), respectively. The follow-up dynamic ultrasound examination showed that the condition of all patients worsened gradually, with the ultrasound scores of lung lesions increasing to varying degrees. Conclusion Though the diagnostic efficacy of bedside ultrasound is relatively low for mild to moderate patients, it is high for severe patients. Bedside ultrasound has important clinical significance for noninvasive assessment and dynamic observation of lung lesions in patients with Coronavirus Disease-19, which is worth further consideration.

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Section: Image Analysismentioning

confidence: 99%

A Clinical Study of Noninvasive Assessment of Lung Lesions in Patients with Coronavirus Disease-19 (COVID-19) by Bedside Ultrasound

et al. 2020

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“…Despite the potential for POCUS to improve clinical care and increasing reports on the sonographic manifestations of COVID‐19, 5,6 the predictive utility of POCUS on clinical outcomes has yet to be determined. However, lung ultrasound (LUS) has already been shown to accurately diagnose a variety of disease states such as pneumothorax, pleural effusions, pneumonia, and interstitial lung disease 2,7 . Common pathological findings with LUS include B‐lines, consolidations, and pleural effusions (Figure 1).…”

Section: Figurementioning

confidence: 99%

Lung Ultrasound Findings in Patients Hospitalized With COVID‐19

Kumar

Weng

Duanmu

et al. 2021

J of Ultrasound Medicine

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Objectives Lung ultrasound (LUS) can accurately diagnose several pulmonary diseases, including pneumothorax, effusion, and pneumonia. LUS may be useful in the diagnosis and management of COVID‐19. Methods This study was conducted at two United States hospitals from 3/21/2020 to 6/01/2020. Our inclusion criteria included hospitalized adults with COVID‐19 (based on symptomatology and a confirmatory RT‐PCR for SARS‐CoV‐2) who received a LUS. Providers used a 12‐zone LUS scanning protocol. The images were interpreted by the researchers based on a pre‐developed consensus document. Patients were stratified by clinical deterioration (defined as either ICU admission, invasive mechanical ventilation, or death within 28 days from the initial symptom onset) and time from symptom onset to their scan. Results N = 22 patients (N = 36 scans) were included. Eleven (50%) patients experienced clinical deterioration. Among N = 36 scans, only 3 (8%) were classified as normal. The remaining scans demonstrated B‐lines (89%), consolidations (56%), pleural thickening (47%), and pleural effusion (11%). Scans from patients with clinical deterioration demonstrated higher percentages of bilateral consolidations (50 versus 15%; P = .033), anterior consolidations (47 versus 11%; P = .047), lateral consolidations (71 versus 29%; P = .030), pleural thickening (69 versus 30%; P = .045), but not B‐lines (100 versus 80%; P = .11). Abnormal findings had similar prevalences between scans collected 0–6 days and 14–28 days from symptom onset. Discussion Certain LUS findings may be common in hospitalized COVID‐19 patients, especially for those that experience clinical deterioration. These findings may occur anytime throughout the first 28 days of illness. Future efforts should investigate the predictive utility of these findings on clinical outcomes.

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“…Collapse: [9] It appears as an area of loss of aeration that is closely similar to that of the consolidation, with the absence of a bronchogram.…”

Section: Significant Pathologies Identified By Lung Ultrasonographymentioning

confidence: 99%

“…Pleural effusion: (Figure 7) [9] Is best detected at the lung base in the posterolateral lung zone with a clear image of the diaphragm in the middle, liver/spleen underneath, and a dark anechoic (Black) fluid above the diaphragm with the lung tissue collapsed above. During lung inflation, the collapsed lung can be seen enhancing into the pleural fluid making a "curtain or jellyfish sign".…”

Section: Significant Pathologies Identified By Lung Ultrasonographymentioning

confidence: 99%

Technique and uses of Lung Ultrasonography in Critical Care Setting

Omar

Attia

Mohammed

et al. 2022

The Egyptian Journal of Intensive Care and Emergency Medicine

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Recently, in the critical care practice, ultrasonography has emerged as a novel method in the diagnosis and management of critically ill patients. Lung ultrasound has been more recently introduced in practice, given the fact that, the passage of ultrasound beam through the interface between different structures creates artifacts and reverberation which is conditionspecific and can be used in the diagnosis.Common conditions i.e., pneumonia, pneumothorax, pleural effusion, and pulmonary edema can be easily diagnosed or at least ruled out by the immediate use of bedside ultrasound in an accurate way without the need for massive experience.Being a bedside, non-invasive and easily applied and easily taught and devoid the risk of radiation and patient transfer for other diagnostic modalities, makes it gains more popularity as a part of Point of Care Ultrasonography (POCUS) in recent medicineThe technique and different uses of lung ultrasound in diagnosis and management of critically ill patients will be explained in this article department to the intensive care unit, from cardiology to pulmonology and nephrology wards.

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Time to embrace POCUS as part of the bedside diagnosis of respiratory diseases

Abstract: See related https://onlinelibrary.wiley.com/doi/10.1111/resp.13659

Cited by 8 publications

References 11 publications

A Clinical Study of Noninvasive Assessment of Lung Lesions in Patients with Coronavirus Disease-19 (COVID-19) by Bedside Ultrasound

A Clinical Study of Noninvasive Assessment of Lung Lesions in Patients with Coronavirus Disease-19 (COVID-19) by Bedside Ultrasound

Lung Ultrasound Findings in Patients Hospitalized With COVID‐19

Technique and uses of Lung Ultrasonography in Critical Care Setting

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