Use of Handheld Ultrasound Device with Artificial Intelligence for Evaluation of Cardiorespiratory System in COVID-19

Abstract

A bstract Background Coronavirus disease-2019 (COVID-19) causes various cardiopulmonary manifestations. Bedside ultrasound helps in the rapid diagnosis of these manifestations. Vscan Extend™ (GE, Wauwatosa, WI, USA) is a handheld ultrasound device with a dual probe and an artificial intelligence application to detect ejection fraction. It can help in reducing the time for diagnosis, duration, and the number of healthcare workers exposed to COVID-19. This is a prospective observational study comparing the cardiorespiratory parameters and time duration for assessment between Vscan Extend™ and the conventional ultrasound machine. Materials and methods Paired observations were made in 96 COVID-19 patients admitted to the intensive care unit by two intensivists. Intensivist A used the Vscan Extend™ device to assess the cardiac function, lung fields, diaphragm, deep veins, and abdomen. Intensivist B used clinical examination, X-ray chest, ECG, and conventional echocardiogram for assessment. The agreement between the findings and the time duration required in both the methods was compared. Results The use of handheld ultrasound has significantly decreased the duration of bedside examination of patients than the conventional method. The median duration of examination using handheld ultrasound was 9 (8.0–11.0) minutes, compared to 20 (17–22) minutes with the conventional method ( P < 0.001). The Cohen's kappa coefficient was 1.0 for left ventricular systolic function, most of the lung fields, and diaphragmatic movement. C onclusion Vscan Extend™ helps in the rapid identification and diagnosis of cardiopulmonary manifestations in COVID-19 patients. The agreement between the handheld device and the conventional method proves its efficacy and safety. CTRI N umber CTRI/2020/07/026701 How to cite this article Maheshwarappa HM, Mishra S, Kulkarni AV, Gunaseelan V, Kanchi M. Use of Handheld Ultrasound Device with Artificial Intelligence for Evaluation of Cardiorespiratory System in COVID-19. J Crit Care Med 2021;25(5):524–527.

Point-of-care ultrasound use in COVID-19: a narrative review

“…A linear probe acquires more optimal images of the pleural line appearance and subpleural changes whereas a curvilinear probe provides a panoramic view from the pleural line to identify B-lines and consolidations ( 48 , 49 ). Handheld pocket-sized ultrasound devices have been shown to have good agreement with standard POCUS scanners when visualising interstitial patterns, consolidation and calculation of LUS score in ICU patients ( 50 ) as well as patients with COVID-19 ( 51 , 52 ). Therefore, handheld pocket-sized ultrasound devices or wireless transducers may be preferable compared to larger POCUS machines during a pandemic as it is more convenient to sheath with single use plastic covers ( 53 ) and easier to disinfect.…”

Inter-System Variability of Eight Different Handheld Ultrasound (HHUS) Devices—A Prospective Comparison of B-Scan Quality and Clinical Significance in Intensive Care

“…Finally, a paper recently appeared, in which five HHUS devices are used for AI-assisted measurement of the optic nerve sheath [ 64 ]. It is to be expected that AI will positively influence both the diagnostic options for the use of HHUS devices and their B-image quality [ 65 , 66 ]. Due to their increasingly acceptable image quality, their compactness, and, not least, their affordable prices, HHUS devices will inevitably be further developed and established within AI-based sonographic diagnostics, and extensively used within telemedical networking.…”

Ultrasonographic Applications of Novel Technologies and Artificial Intelligence in Critically Ill Patients

“…Point-of-care ultrasound (POCUS) has a wide diagnostic application in intensive care, making it easier to use and interpret such imaging modalities as transthoracic and transesophageal echocardiography, lung ultrasound, ultrasound of a patient in shock, and patients with other life-threatening conditions. Due to the complexity of ultrasound assessment in intensive care, the physician’s purpose of using AI in this setting is to help assess the patient’s condition based on US imaging of various systems and organs and assess the patient’s hemodynamic profile [ 4 , 5 , 6 ]. The literature has shown that AI-guided POCUS will most likely increase the efficiency and effectiveness of ultrasound imaging [ 4 , 7 ].…”

“…Due to the complexity of ultrasound assessment in intensive care, the physician’s purpose of using AI in this setting is to help assess the patient’s condition based on US imaging of various systems and organs and assess the patient’s hemodynamic profile [ 4 , 5 , 6 ]. The literature has shown that AI-guided POCUS will most likely increase the efficiency and effectiveness of ultrasound imaging [ 4 , 7 ]. AI-supported point-of-care protocols also have particular educational applications, enabling young medical students to improve ultrasound techniques and increasing the identifiability of anatomical structures, which is necessary to perform procedures [ 8 ].…”

“…In this complex setting, AI comes to the aid of clinicians [ 9 ]. Depending on the type of software, it helps detect key structures for performing a specific medical procedure, such as cannulation, finding the optimal ultrasound plane for imaging of the heart, lungs, or abdominal organs [ 4 , 10 ] as well as setting the appropriate image quality, and performing measurements, including complex Doppler measurements [ 11 ]. At the same time, it significantly reduces the time needed to learn how to perform imaging and the time to acquire clinically significant images, and it improves the accuracy of the obtained results [ 2 , 10 , 12 , 13 ].…”