05 / Early diagnosis of a ventilator-associated pneumonia: role of bedside lung ultrasound

Author(s):  
Marc Vives
CHEST Journal ◽  
2016 ◽  
Vol 149 (4) ◽  
pp. 969-980 ◽  
Author(s):  
Silvia Mongodi ◽  
Gabriele Via ◽  
Martin Girard ◽  
Isabelle Rouquette ◽  
Benoit Misset ◽  
...  

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Mohammed Ibrahim ◽  
Ahmed Omran ◽  
Mostafa Ibrahim ◽  
Nouran Bioumy ◽  
Sonya El-Sharkawy

Neonatal pneumonia is reported to be the primary cause of neonatal respiratory failure and one of the common causes of neonatal hospitalization and death in developing countries. Chest X-ray was considered the gold standard for diagnosis of neonatal pneumonia. Lung ultrasonography has been described as a valuable noninvasive tool for the diagnosis of many neonatal pulmonary diseases. We report a case of ventilation associated neonatal pneumonia with very early diagnosis using lung ultrasound before any significant radiographic changes in chest X-ray or laboratory findings suggestive of infection.


2017 ◽  
Vol 33 (8) ◽  
pp. 447-455 ◽  
Author(s):  
Leonardo Jönck Staub ◽  
Roberta Rodolfo Mazzali Biscaro ◽  
Rosemeri Maurici

Background: Lung ultrasound (LUS) is an accurate tool to diagnose community-acquired pneumonia. However, it is not yet an established tool to diagnose ventilator-associated pneumonia (VAP). Purpose: To assess the evidence about LUS in the diagnosis of VAP, we conducted a systematic review of the literature. Methods: We searched PubMed, Embase, Scopus, Web of Science, and LILACS. Two researchers independently selected the studies that met the inclusion criteria. Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of the studies. In a qualitative synthesis, 3 questions guided the review: Q1. What are the sonographic signs of VAP? Q2. How can LUS be combined with others tests or signs of VAP? Q3. What is the role of LUS in VAP screening? Main Results: Three studies (n = 377 patients) with different designs were included. In terms of Q1, the 3 studies assessed the accuracy of sonographic consolidations. In patients suspected for VAP, lobar or hemilobar consolidation alone was not sufficient to diagnose VAP but seems useful to exclude it. The most useful signs were small subpleural consolidations (sensitivity: 81%; specificity: 41%) and dynamic air bronchograms (sensitivity: 44%; specificity: 81%). Two studies were assessed for Q2, when the 2 signs above were included in a clinical score (Ventilator-associated Pneumonia Lung Ultrasound Score associated with quantitative culture of endotracheal aspirate—VPLUS-EAquant), the accuracy was amplified (sensitivity: 48% and specificity: 97% for score ≥4; sensitivity: 78% and specificity: 77% for score ≥3 points). Finally, regarding Q3, no studies have assessed the use of LUS in screening of VAP. Conclusion: Small subpleural consolidations and dynamic air bronchograms were the most useful sonographic signs to diagnose VAP in suspected patients. Clinical scores including LUS had better diagnosis accuracy than LUS alone. There are no data on LUS for VAP screening.


2019 ◽  
Vol 87 (June) ◽  
pp. 1987-1996
Author(s):  
AHMED A. ABD EL-WAHED, M.Sc. THANAA M. AL-NOMANY, M.D. ◽  
AHMED A. ABD EL-HAFEZ, M.D. AHMED D. ABO HAMAR, M.D.

Author(s):  
Ashley Miller

Lung ultrasound can be used to diagnose most pathologies which cause respiratory failure. This chapter will outline a systematic approach to assessing the patient presenting with acute respiratory failure. In addition, the role of ultrasound in assessing ventilated patients with established respiratory failure, monitoring fluid balance and pleural effusions, identifying ventilator-associated pneumonia, and monitoring lung recruitment will be reviewed.


2019 ◽  
Vol 98 (5) ◽  
pp. 175-178
Author(s):  
E.Yu. Radtsig ◽  
◽  
E.N. Kotova ◽  
M.R. Bogomilskiy ◽  
I.E. Bulynko ◽  
...  

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