scholarly journals Lung Ultrasound in COVID-19 pandemic: Why? How? And When?

2020 ◽  
pp. 3-12
Author(s):  
Khrystyna Pronyuk ◽  
Andriy Vysotskyi
Keyword(s):  
Critically Ill ◽  
Computer Tomography ◽  
Critically Ill Patients ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Clinical Decision ◽  
X Rays ◽  
Lung Involvement ◽  
X Ray ◽  
Chest X Ray

During COVID-19 pandemic Lung ultrasound has rapidly become a tool for diagnosis and monitoring of lung involvement and it’s severity. Accurate evaluation of lung pathologic entities at the bedside, especially in critically ill patients, and those on mechanical ventilation, remains problematic. CT should not be frequently repeated and is not available everywhere, especially for critically ill patients. Limitations of bedside chest X-ray have been well described and lead to poor-quality X-ray films with low sensitivity.The lung ultrasound has been shown to be a useful tool in intensive care patients with adult respiratory distress syndrome (ARDS) and can be used forassessing severity of lung involvement in COVID-19. In this paper the accuracy of bedside LUS, chest X-ray and computer tomography are compared based on clinical cases, typical for COVID-19 lung ultrasound appearance is evaluated. There have been shown that lung ultrasound can predict the deterioration of the patient's conditionand can be used for risk stratification and clinical decision making, reducethe use of both chest x‐rays and computer tomography, what is very important especially in limited resources settings.

scholarly journals LUNG ULTRASOUND DURING COVID-19 PANDEMICS: WHY, HOW AND WHEN?

2021 ◽  
Vol 74 (8) ◽  
pp. 1783-1788
Author(s):  
Khrystyna O. Pronyuk ◽  
Liudmyla O. Kondratiuk ◽  
Andrii D. Vysotskyi ◽  
Olga A. Golubovska ◽  
Iryna M. Nikitina
Keyword(s):  
Hospital Stay ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Limited Resource ◽  
Clinical Decision ◽  
Lung Damage ◽  
Dynamic Monitoring ◽  
Initial Assessment ◽  
X Ray ◽  
Chest X Ray

The aim: To optimize diagnostic of pathological processes in lungs affected by COVID-19, dynamic monitoring and clinical decision making using lung ultrasound in limited resources settings. Materials and methods: Between the onset of pandemics and January 2021, approximately 9000 patients have been treated for confirmed COVID-19 in the Olexandrivska Clinical Hospital. Assessment of all hospitalized patients included hematology, chemistries and proinflammatory cytokines – IL-6, CRP, procalcitonin, ferritin. Diagnosis was confirmed by PCR for SARS-CoV-2 RNA. Chest X-ray was performed in all hospitalized cases, while CT was available approximately in 30% of cases during hospital stay. Lung ultrasound was proactively utilized to assess the type and extent of lung damage and to monitor the progress of disease in patients hospitalized into the ICU and Infection Unit (n=135). Ultrasound findings were recorded numerically based on scales. Results: In the setting of СOVID-19, bedside lung ultrasound has been promptly recognized as a tool to diagnose and monitor the nature and extent of lung injury. Lung ultrasound is a real time assessment, which helps determine the nature of a pathologic process affecting lungs. In this paper the accuracy of bedside LUS, chest X-ray and computer tomography are compared based on clinical cases, typical for COVID-19 lung ultrasound appearance is evaluated. Described in article data is collected in one of the biggest facility that deals with COVID-19. Chest X-ray was performed in all hospitalized cases, while CT was available approximately in 30% of cases during hospital stay. The cases presented in the paper indicate potential advantages to the use of ultrasound in limited resource healthcare settings, especially when the risk of transportation to CT outweighs the value of information obtained. Conclusions: Grading of ultrasonographic findings in the lungs was sufficient for both initial assessment with identification of high risk patients, and routine daily monitoring. Hence, lung ultrsound may be used to predict deterioration, stratify risks and make clinical decisions.

Impact of lung ultrasound on clinical decision making in critically ill patients

2013 ◽  
Vol 40 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Nektaria Xirouchaki ◽  
Eumorfia Kondili ◽  
George Prinianakis ◽  
Polychronis Malliotakis ◽  
Dimitrios Georgopoulos
Keyword(s):  
Decision Making ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Clinical Decision

Evaluation Of The Role Of Bedside Lung Ultrasound Versus Chest X-ray In Critically Ill Patients

2019 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Nermeen Ali ◽  
Hassan Maguid ◽  
Neven Gamil ◽  
Mohamed Tawfeek ◽  
Sameh Hegab
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Lung Ultrasound ◽  
X Ray ◽  
Chest X Ray

Use And Influence Of Lung Ultrasound On Clinical Decision Making In Critically Ill Patients

2010 ◽  
Author(s):  
Nektaria Xirouchaki ◽  
Maria Plataki ◽  
DHMHTRHS BABALIS ◽  
LEFTERIS MAGKANAS ◽  
VAGGELIS KANIARIS ◽  
...  
Keyword(s):  
Decision Making ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Clinical Decision

The Diagnostic Role of Lung Ultrasound in Critically Ill Patients In Comparison With Chest X-Ray

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mina Fayez Hanna ◽  
Fahmy Saad Latef ◽  
Ahmed Mohamed El-Sayed El-Hennawy ◽  
Wessam Zaher Selima
Keyword(s):  
Pleural Effusion ◽  
Critically Ill ◽  
Sensitivity And Specificity ◽  
Critically Ill Patients ◽  
Lung Ultrasound ◽  
Low Cost ◽  
Acute Dyspnea ◽  
X Ray ◽  
Pleural Diseases ◽  
Chest X Ray

Abstract Purpose To compare between lung ultrasound and chest X-ray in diagnosis of different lung pathologies in critically ill patients using lung CT as a gold standard. Methods Comparative prospective randomized single group observational study was conducted in the Critical Care unit (medical and surgical ICU). The study was conducted upon fifty patients (28 females &22 males) with a mean age of 58 years (SD ± 15.55; (19 - 82) presented to Kom Hamadah Hospital during a period of one year starting from July 2018 to July 2019, with acute dyspnea as the primary complaint or developed acute dyspnea and or tachypnea during their ICU stay were evaluated for the presence of pleural effusion, pneumothorax, alveolar-Interstitial Pathology and consolidation by LUS and CXR for detecting the sensitivity and specificity of each modality with CT chest done as a reference in cases of doubt. Results The comparison between Sensitivity and Specificity of US finding was (86.8% for parenchymal disease, 100.0% for pleural diseases) and (100.0% for parenchymal diseases, 94.7% for pleural diseases) respectively while CXR finding was (65.8% for parenchymal diseases, 75.0% for pleural diseases) and (58.3% for parenchymal diseases), (92.1% for pleural diseases) respectively among studied patients. Conclusion Transthoracic ultrasound is valuable for the evaluation of a wide variety of chest diseases, particularly mechanically ventilated patient. The advantages of low cost, bedside availability and no radiation exposure have made ultrasound an indispensable diagnostic tool in ICU. Lung ultrasound is more sensitive than chest x-ray in diagnosis and follow up chest diseases) PNX, alveolar-interstitial syndromes, parenchymal consolidations, and pleural effusion (LUS is an interesting medical method that is complementary to bedside CXR and reduces the need to use a CT scan.

scholarly journals Lung Ultrasonography and Chest Radiography in Suspected Cases of Pneumonia in Critically Ill Patients- A Comparative Study

2020 ◽  
Vol 8 (2) ◽  
pp. 88-90
Author(s):  
Bharat M.P ◽  
Deepak K.S
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Chest Radiography ◽  
Lung Ultrasound ◽  
Age Group ◽  
Lung Ultrasonography ◽  
Predictive Values ◽  
X Ray ◽  
Chest X Ray ◽  
The Difference

Background: The present study compared lung ultrasound (USG) and chest radiography in suspected cases of pneumonia in critically ill patients. Subjects & Methods: 56 patients age above 20 years of age of both genders diagnosed with pneumonia were included. Patients were subjected to chest USG and X ray. Positive predictive values for both lung ultrasound and chest X-ray were calculated. Results: Age group 20-30 years had 4 patients, 30-40 years had 6, 40-50years had 10, 50-60 years had 16 and >60 years had 20 patients. The difference was significant (P< 0.05). Chest x ray reveled 40 out of 56 cases positive and 16 negative and USH showed 52 positive and 4 negative. Positive predictive value (PPV) of chest x- ray was 71.4% and USG was 92.8%. The difference was significant (P< 0.05). Conclusion: Lung ultrasound is an effective radiological tool for the assessment of suspected cases of pneumonia as compared to chest x ray.

scholarly journals EVALUATION OF THE ROLE OF BEDSIDE LUNG ULTRASOUND VERSUS CHEST X-RAY IN CRITICALLY ILL PATIENTS

2019 ◽  
Vol 25 (6) ◽  
pp. 887-897
Author(s):  
Nermeen Ali ◽  
Hassan Maguid ◽  
Neven Gamil ◽  
Mohamed Tawfeek ◽  
Sameh Hegab
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Lung Ultrasound ◽  
X Ray ◽  
Chest X Ray

scholarly journals Which role for chest x-ray score in predicting the outcome in COVID-19 pneumonia?

2020 ◽  
Author(s):  
Roberto Maroldi ◽  
Paolo Rondi ◽  
Giorgio Maria Agazzi ◽  
Marco Ravanelli ◽  
Andrea Borghesi ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Scoring System ◽  
Clinical Decision Making ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Lung Involvement ◽  
X Ray ◽  
Entire Cohort ◽  
Discharged Patients ◽  
Chest X Ray

Abstract Objective We aim to demonstrate that a chest X-ray (CXR) scoring system for COVID-19 patients correlates with patient outcome and has a prognostic value. Methods This retrospective study included CXRs of COVID-19 patients that reported the Brixia score, a semi-quantitative scoring system rating lung involvement from 0 to 18. The highest (H) and lowest (L) values were registered along with scores on admission (A) and end of hospitalization (E). The Brixia score was correlated with the outcome (death or discharge). Results A total of 953 patients met inclusion criteria. In total, 677/953 were discharged and 276/953 died during hospitalization. A total of 524/953 had one CXR and 429/953 had more than one CXR. H-score was significantly higher in deceased (median, 12; IQR 9–14) compared to that in discharged patients (median, 8; IQR 5–11) (p < 0.0001). In 429/953 patients with multiple CXR, A-score, L-score, and E-score were higher in deceased than in discharged patients (A-score 9 vs 8; p = 0.039; L-score 7 vs 5; p < 0.0003; E-score 12 vs 7; p < 0.0001). In the entire cohort, logistic regression showed a significant predictive value for age (p < 0.0001, OR 1.13), H-score (p < 0.0001, OR 1.25), and gender (p = 0.01, male OR 1.67). AUC was 0.863. In patients with ≥ 2 CXR, A-, L-, and E-scores correlated significantly with the outcome. Cox proportional hazards regression indicated age (p < 0.0001, HR 4.17), H-score (< 9, HR 0.36, p = 0.0012), and worsening of H-score vs A score > 3 (HR 1.57, p = 0.0227) as associated with worse outcome. Conclusions The Brixia score correlates strongly with disease severity and outcome; it may support the clinical decision-making, particularly in patients with moderate-to-severe signs and symptoms. The Brixia score should be incorporated in a prognostic model, which would be desirable, particularly in resource-constraint scenarios. Key Points • To demonstrate the importance of the Brixia score in assessing and monitoring COVID-19 lung involvement. • The Brixia score strongly correlates with patient outcome and can be easily implemented in the routine reporting of CXR.

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