Novel use of a lung ultrasound sensor for detection of lung interstitial syndrome

2021 ◽  
Vol 150 (4) ◽  
pp. A33-A33
Author(s):  
Tatiana D. Khokhlova ◽  
Adam Maxwell ◽  
Gilles P. Thomas ◽  
Jeff Thiel ◽  
Alex T. Peek ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Interstitial Syndrome ◽  
Ultrasound Sensor

scholarly journals Lung ultrasound presentation of COVID-19 patients: phenotypes and correlations

2021 ◽  
Author(s):  
Gianmarco Secco ◽  
◽  
Marzia Delorenzo ◽  
Francesco Salinaro ◽  
Caterina Zattera ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Ultrasound ◽  
Structure And Function ◽  
General Ward ◽  
Prognostic Role ◽  
Interstitial Syndrome ◽  
Lung Structure ◽  
And Function ◽  
The Relationship

AbstractBedside lung ultrasound (LUS) can play a role in the setting of the SarsCoV2 pneumonia pandemic. To evaluate the clinical and LUS features of COVID-19 in the ED and their potential prognostic role, a cohort of laboratory-confirmed COVID-19 patients underwent LUS upon admission in the ED. LUS score was derived from 12 fields. A prevalent LUS pattern was assigned depending on the presence of interstitial syndrome only (Interstitial Pattern), or evidence of subpleural consolidations in at least two fields (Consolidation Pattern). The endpoint was 30-day mortality. The relationship between hemogasanalysis parameters and LUS score was also evaluated. Out of 312 patients, only 36 (11.5%) did not present lung involvment, as defined by LUS score < 1. The majority of patients were admitted either in a general ward (53.8%) or in intensive care unit (9.6%), whereas 106 patients (33.9%) were discharged from the ED. In-hospital mortality was 25.3%, and 30-day survival was 67.6%. A LUS score > 13 had a 77.2% sensitivity and a 71.5% specificity (AUC 0.814; p < 0.001) in predicting mortality. LUS alterations were more frequent (64%) in the posterior lower fields. LUS score was related with P/F (R2 0.68; p < 0.0001) and P/F at FiO2 = 21% (R2 0.59; p < 0.0001). The correlation between LUS score and P/F was not influenced by the prevalent ultrasound pattern. LUS represents an effective tool in both defining diagnosis and stratifying prognosis of COVID-19 pneumonia. The correlation between LUS and hemogasanalysis parameters underscores its role in evaluating lung structure and function.

scholarly journals Interstitial syndrome-lung ultrasound B lines: a potential marker for pulmonary metastases? A case series

2018 ◽  
Vol 12 (3) ◽  
pp. 223-226 ◽  
Author(s):  
Maria Viviana Carlino ◽  
Costantino Mancusi ◽  
Giovanni De Simone ◽  
Filomena Liccardi ◽  
Mario Guarino ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Pulmonary Metastases ◽  
Lung Metastases ◽  
Point Of Care ◽  
Case Series ◽  
Point Of Care Ultrasound ◽  
Interstitial Syndrome ◽  
Potential Marker ◽  
Bilateral Lung ◽  
Enhanced Computed Tomography

Four patients presented to the Emergency Department with dyspnea and they underwent point-of-care ultrasound. Lung ultrasound showed a diffuse bilateral B-profile pattern-interstitial syndrome, they underwent contrast-enhanced computed tomography scan of thorax that showed multiple bilateral lung metastases. The detection, in a dyspneic patient, of a diffuse Bprofile pattern not attributable to traditional interstitial syndrome conditions (pulmonary fibrosis, acute respiratory distress syndrome, acute pulmonary edema, interstitial pneumonia) could be indicative of multiple pulmonary metastases.

scholarly journals Novel approaches to ultrasonography of the lung and pleural space: where are we now?

Breathe ◽  
2017 ◽  
Vol 13 (2) ◽  
pp. 100-111 ◽  
Author(s):  
Daniel Lichtenstein
Keyword(s):  
Pulmonary Embolism ◽  
Cardiac Arrest ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Critically Ill ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
List Type ◽  
Interstitial Syndrome

This review article is an update of what should be known for practicing basic lung ultrasound in the critically ill (LUCI) and is also of interest for less critical disciplines (e.g. pulmonology). It pinpoints on the necessity of a professional machine (not necessarily a sophisticated one) and probe. It lists the 10 main signs of LUCI and some of the main protocols made possible using LUCI: the BLUE protocol for a respiratory failure, the FALLS protocol for a circulatory failure, the SESAME protocol for a cardiac arrest and the investigation of a ventilated acute respiratory distress syndrome patient, etc. It shows how the field has been fully standardised to avoid confusion.Key pointsA simple ultrasonography unit is fully adequate, with minimal filters, and provides a unique probe for integrating the lung into a holistic, whole-body approach to the critically ill.Interstitial syndrome is strictly defined. Its clinical relevance in the critically ill is standardised for defining haemodynamic pulmonary oedema, pneumonia and pulmonary embolism.Pneumothorax is strictly and sequentially defined by the A′-profile (at the anterior wall in a supine or semirecumbent patient, abolished lung siding plus the A-line sign) and then the lung point.The BLUE protocol integrates lung and venous ultrasound findings for expediting the diagnosis of acute respiratory failure, following pathophysiology, allowing prompt diagnosis of pneumonia, haemodynamic pulmonary oedema, exacerbated chronic obstructive pulmonary disease or asthma, pulmonary embolism or pneumothorax, even in clinically challenging presentations.Educational aimsTo understand that the use of lung ultrasound, although long standardised, still needs educational efforts for its best use, a suitable machine, a suitable universal probe and an appropriate culture.To be able to use a terminology that has been fully standardised to avoid any confusion of useless wording.To understand the logic of the BLUE points, three points of interest enabling expedition of a lung ultrasound examination in acute respiratory failure.To be able to cite, in the correct hierarchy, the seven criteria of the B-line, then those of interstitial syndrome.To understand the sequential thinking when making ultrasound diagnosis of pneumothorax.To be able to use the BLUE protocol for building profiles of pneumonia (or acute respiratory distress syndrome) and understand their limitations.To understand that lung ultrasound can be used for the direct analysis of an acute respiratory failure (the BLUE protocol), an acute circulatory failure (the FALLS protocol) and even a cardiac arrest (SESAME protocol), following a pathophysiological approach.To understand that the first sequential target in the SESAME protocol (search first for pneumothorax in cardiac arrest) can also be used in countless more quiet settings of countless disciplines, making lung ultrasound in the critically ill cost-, time- and radiation-saving.To be able to perform a BLUE protocol in challenging patients, understanding how the best lung ultrasound can be obtained from bariatric or agitated, dyspnoeic patients.

scholarly journals One year of SARS-CoV-2 and lung ultrasound: what has been learned and future perspectives

2021 ◽  
Author(s):  
Andrea Boccatonda ◽  
Giulio Cocco ◽  
Eugenia Ianniello ◽  
Marco Montanari ◽  
Damiano D’Ardes ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Relevant Information ◽  
Pulmonary Involvement ◽  
Future Perspectives ◽  
Interstitial Syndrome ◽  
Current Infection ◽  
Good Diagnostic Accuracy ◽  
One Year ◽  
B Lines ◽  
Over Time

AbstractA first screening by ultrasound can be relevant to set a specific diagnostic and therapeutic route for a patient with a COVID-19 infection. The finding of bilateral B-lines and white lung areas with patchy peripheral distribution and sparing areas is the most suggestive ultrasound picture of COVID-19 pneumonia. Failure to detect bilateral interstitial syndrome (A pattern) on ultrasound excludes COVID-19 pneumonia with good diagnostic accuracy, but does not exclude current infection. The use of shared semiotic and reporting schemes allows the comparison and monitoring of the COVID-19 pulmonary involvement over time. This review aims to summarise the main data on pulmonary ultrasound and COVID-19 to provide accurate and relevant information for clinical practice.

scholarly journals Lung ultrasound in a tertiary intensive care unit population: a diagnostic accuracy study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Jasper M. Smit ◽  
Mark E. Haaksma ◽  
Michiel H. Winkler ◽  
Micah L. A. Heldeweg ◽  
Luca Arts ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Lung Ultrasound ◽  
Diagnostic Accuracy Study ◽  
Reference Test ◽  
Interstitial Syndrome ◽  
Thoracic Ct ◽  
Accuracy Study ◽  
Respiratory Conditions

Abstract Background Evidence from previous studies comparing lung ultrasound to thoracic computed tomography (CT) in intensive care unit (ICU) patients is limited due to multiple methodologic weaknesses. While addressing methodologic weaknesses of previous studies, the primary aim of this study is to investigate the diagnostic accuracy of lung ultrasound in a tertiary ICU population. Methods This is a single-center, prospective diagnostic accuracy study conducted at a tertiary ICU in the Netherlands. Critically ill patients undergoing thoracic CT for any clinical indication were included. Patients were excluded if time between the index and reference test was over eight hours. Index test and reference test consisted of 6-zone lung ultrasound and thoracic CT, respectively. Hemithoraces were classified by the index and reference test as follows: consolidation, interstitial syndrome, pneumothorax and pleural effusion. Sensitivity, specificity, positive and negative likelihood ratio were estimated. Results In total, 87 patients were included of which eight exceeded the time limit and were subsequently excluded. In total, there were 147 respiratory conditions in 79 patients. The estimated sensitivity and specificity to detect consolidation were 0.76 (95%CI: 0.68 to 0.82) and 0.92 (0.87 to 0.96), respectively. For interstitial syndrome they were 0.60 (95%CI: 0.48 to 0.71) and 0.69 (95%CI: 0.58 to 0.79). For pneumothorax they were 0.59 (95%CI: 0.33 to 0.82) and 0.97 (95%CI: 0.93 to 0.99). For pleural effusion they were 0.85 (95%CI: 0.77 to 0.91) and 0.77 (95%CI: 0.62 to 0.88). Conclusions In conclusion, lung ultrasound is an adequate diagnostic modality in a tertiary ICU population to detect consolidations, interstitial syndrome, pneumothorax and pleural effusion. Moreover, one should be careful not to interpret lung ultrasound results in deterministic fashion as multiple respiratory conditions can be present in one patient. Trial registration This study was retrospectively registered at Netherlands Trial Register on March 17, 2021, with registration number NL9344.

Bedside lung ultrasound in the assessment of alveolar-interstitial syndrome

2006 ◽  
Vol 24 (6) ◽  
pp. 689-696 ◽  
Author(s):  
Giovanni Volpicelli ◽  
Alessandro Mussa ◽  
Giorgio Garofalo ◽  
Luciano Cardinale ◽  
Giovanna Casoli ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Interstitial Syndrome

Lung Ultrasound Predicts Interstitial Syndrome and Hemodynamic Profile in Parturients With Severe Preeclampsia

2014 ◽  
Vol 58 (6) ◽  
pp. 286
Author(s):  
Laurent Zieleskiewicz ◽  
Claire Contargyris ◽  
Clément Brun ◽  
Maxime Touret ◽  
Armand Vellin ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Severe Preeclampsia ◽  
Interstitial Syndrome ◽  
Hemodynamic Profile

scholarly journals Lung ultrasound may support internal medicine physicians in predicting the diagnosis, bacterial etiology and favorable outcome of community-acquired pneumonia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Filippo Mearelli ◽  
Chiara Casarsa ◽  
Alessandro Trapani ◽  
Pierlanfranco D’agaro ◽  
Cristina Moras ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Lung Ultrasound ◽  
Characteristic Curve ◽  
Community Acquired Pneumonia ◽  
Adverse Outcomes ◽  
Favorable Outcome ◽  
Predictive Values ◽  
Interstitial Syndrome ◽  
Chest X Ray ◽  
Viral Etiologies

AbstractTo assess the usefulness of lung ultrasound (LUS) for identifying community-acquired pneumonia (CAP) among adult patients with suspected lower respiratory tract infection (LRTI) and for discriminating between CAP with different cultural statuses, etiologies, and outcomes. LUS was performed at internal medicine ward admission. The performance of chest X-ray (CXR) and LUS in diagnosing CAP in 410 patients with suspected LRTI was determined. All possible positive results for pneumonia on LUS were condensed into pattern 1 (consolidation + / − alveolar-interstitial syndrome) and pattern 2 (alveolar-interstitial syndrome). The performance of LUS in predicting culture-positive status, bacterial etiology, and adverse outcomes of CAP was assessed in 315 patients. The area under the receiver operating characteristic curve for diagnosing CAP by LUS was significantly higher than for diagnosis CAP by CXR (0.93 and 0.71, respectively; p < 0.001). Pattern 1 predicted CAP with bacterial and mixed bacterial and viral etiologies with positive predictive values of 99% (95% CI, 94–100%) and 97% (95% CI, 81–99%), respectively. Pattern 2 ruled out mortality with a negative predictive value of 95% (95% CI, 86–98%), respectively. In this study, LUS was useful in predicting a diagnosis of CAP, the bacterial etiology of CAP, and favorable outcome in patients with CAP.

scholarly journals Lung Ultrasound in COVID-19 Patients: Characteristics and Factors Affecting its Diagnostic Accuracy

2021 ◽  
Author(s):  
Yilian Duan ◽  
Wen Zhang ◽  
Qian Li ◽  
Li Ji ◽  
Chunyan Cao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Logistic Regression ◽  
Pleural Effusion ◽  
Disease Duration ◽  
Lung Ultrasound ◽  
Binary Logistic Regression ◽  
Chest Ct ◽  
Interstitial Syndrome ◽  
Factors Influencing ◽  
Chest Ct Scan

Abstract Background: Although chest computed tomography (CT) is the gold standard for diagnosing the majority of lung conditions, its use in screening patients for coronavirus disease 2019(COVID-19) pneumonia is not recommended. Lung ultrasound (LUS) is an alternative modality. To investigate the characteristics and diagnostic accuracy (DA) of bedside ultrasound for lung lesions in patients with COVID-19 and to determine the factors influencing the DA of lung ultrasound (LUS).Methods: A total of 330 patients with COVID-19 admitted to the hospital between February and March 2020 were retrospectively recruited. The imaging characteristics of LUS and computed tomography (CT) scans were analysed and summarized. DA was calculated using a chest CT scan as the reference standard. Furthermore, a binary logistic regression analysis was conducted to investigate the factors influencing the DA of LUS for interstitial syndrome. Results: The ultrasound findings of COVID-19 patients presented mainly as B lines (195/330, 59.1%), unsmooth or interrupted pleural lines (118/330, 35.8%), consolidation lesions (74/330, 22.4%), and pleural effusion (11/330, 3.33%). Compared with the chest CT scan, the DA of LUS for interstitial syndrome, consolidation, pleural effusion, and pleural thickening were 0.821, 0.927, 0.988, and 0.863, respectively. The diagnostic coincidence rate of LUS and chest CT in the mild, common, severe, and critical groups were 93%, 68.6%, 100%, and 100%, respectively. According to the results of the binary logistic regression, sex, disease duration, experience of the doctor, and involved lobes were independent predictors of the DA for interstitial syndrome.Conclusions: LUS had good diagnostic performance for diagnosing COVID-19 pneumonia, and showed a relatively low DA for interstitial syndrome. Female sex, doctors with less experience, long disease duration, and lesions limited to the upper or lower lobes may decrease the DA.

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