Computer-Aided Quantitative Ultrasonography for Detection of Pulmonary Edema in Mechanically Ventilated Cardiac Surgery Patients

Corradi, Francesco; Brusasco, Claudia; Vezzani, Antonella; Santori, Gregorio; Manca, Tullio; Ball, Lorenzo; Nicolini, Francesco; Gherli, Tiziano; Brusasco, Vito

doi:10.1016/j.chest.2016.04.013

Cited by 72 publications

(58 citation statements)

References 22 publications

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“…For LUS examination we used a 4 cm wide high-frequency linear probe (7 MHz, Vivid-I TM GE Healthcare-Milwaukee, WI, USA); although no indications on the best probe to assess lung aeration are reported in the International Consensus Conference [1], the linear probe allows the best visualization of the pleura, thanks to its high frequency and high superficial resolution, and for this reason has already been used for lung aeration assessment in previous studies [20,21]. Patients were examined in semi-recumbent position applying the probe perpendicularly to the chest surface.…”

Section: Ultrasound Examinationmentioning

confidence: 99%

Modified Lung Ultrasound Score for Assessing and Monitoring Pulmonary Aeration

et al. 2017

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Lung Ultrasound Score (LUSS) is a useful tool for lung aeration assessment but presents two theoretical limitations. First, standard LUSS is based on longitudinal scan and detection of number/coalescence of B lines. In the longitudinal scan pleura visualization is limited by intercostal space width. Moreover, coalescence of B lines to define severe loss of aeration is not suitable for non-homogeneous lung pathologies where focal coalescence is possible. We therefore compared longitudinal vs. transversal scan and also cLUSS (standard coalescence-based LUSS) vs. qLUSS (quantitative LUSS based on % of involved pleura). 38 ICU patients were examined in 12 thoracic areas in longitudinal and transversal scan. B lines (number, coalescence), subpleural consolidations (SP), pleural length and pleural involvement (> or ≤ 50 %) were assessed. cLUSS and qLUSS were computed in longitudinal and transversal scan. Transversal scan visualized wider (3.9 [IQR 3.8 - 3.9] vs 2.0 [1.6 - 2.5] cm, p< 0.0001) and more constant (variance 0.02 vs 0.34 cm, p < 0.0001) pleural length, more B lines (70 vs 59 % of scans, p < 0.0001), coalescence (39 vs 28 %, p < 0.0001) and SP (22 vs 14 %, p < 0.0001) compared to longitudinal scan. Pleural involvement > 50 % was observed in 17 % and coalescence in 33 % of cases. Focal coalescence accounted for 52 % of cases of coalescence. qLUSS-transv generated a different distribution of aeration scores compared to cLUSS-long (p < 0.0001). In unselected ICU patients, variability of pleural length in longitudinal scans is high and focal coalescence is frequent. Transversal scan and quantification of pleural involvement are simple measures to overcome these limitations of LUSS.

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Section: Ultrasound Examinationmentioning

confidence: 99%

Modified Lung Ultrasound Score for Assessing and Monitoring Pulmonary Aeration

et al. 2017

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“…This has already been shown to provide a promising and reliable operator-independent assessment of lung surface density ( Fig. 1), which seems to outperform previously described subjective scores [4][5][6].…”

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confidence: 66%

Lung ultrasound and B-lines quantification inaccuracy: B sure to have the right solution

et al. 2020

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Dear Editor,We read with great interest the letter form Haaksma and co-workers titled "Lung ultrasound and B-lines: B careful!" [1]. The authors found that lung ultrasound (LUS) reproducibility of B-lines detection with different transducers and raters was poor to moderate and raised a relevant issue.B-lines are dynamic LUS artifacts, moving and potentially changing appearance over the respiratory cycle, associated with increased extravascular lung water or partial lung loss of aeration. Although the recognition of B-lines and discrimination of A-from B-pattern are simple tasks, the quantification of B-lines and the assessment of their spacing can be challenging: easily counted when few, it becomes impossible to enumerate them precisely when numerous and tending to merge (as often happens in the interstitial-alveolar syndromes).Semiquantitative methods have been proposed to quantify B-lines based on visual estimation of screen percentage occupied by them [2] or on the presence/absence of their coalescence [3]. These methods may be prone to errors either due to inter-operator "eyeballing" variability or to assessment of their coalescence without considering its overall pleural extension.The current recommendation to assess the percentage of pleural line occupied by B-lines (rather than counting their maximum number over each ultrasound scan) [2] may also lead to inaccurate results.At present, no tool is available to quantify the percentage of pleural line occupied by B-lines. This may not be a simple cognitive process because: (1) the distance

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“…A literature review has revealed that, apart from these diagnostic approaches in ICUs, LUS is also helpful in managing ventilated patients, from confirmation of endotracheal intubation to initiation of mechanical ventilation and prediction of weaning outcome. 26,27 The reduction of ventilator-related barotraumas through optimal PEEP and opening pressures are routinely practiced, 28 whereby LUS can be a useful imaging tool for quantifying lung volume during mechanical ventilation, 29 thereby preventing associated injuries.…”

Section: Clinical Applications Of Lung Ultrasoundmentioning

confidence: 99%

Lung Ultrasound: The Emerging Role of Respiratory Therapists

et al. 2019

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Lung ultrasound is a point-of-care imaging tool that is routinely used in acute care medicine. Traditionally, radiology physicians were the primary practitioners of diagnostic ultrasound, but with the recognition of its importance in intensive care medicine, critical care physicians have also adopted this practice. Within the intensive care unit inter-professional team is the respiratory therapist, who participates actively in the care of ventilated patients. Their scope of responsibility is expanding with newer technologies being brought into clinical use on a regular basis. This review focuses on the scope and benefits of ultrasound training within respiratory care-related areas.

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Computer-Aided Quantitative Ultrasonography for Detection of Pulmonary Edema in Mechanically Ventilated Cardiac Surgery Patients

Cited by 72 publications

References 22 publications

Modified Lung Ultrasound Score for Assessing and Monitoring Pulmonary Aeration

Modified Lung Ultrasound Score for Assessing and Monitoring Pulmonary Aeration

Lung ultrasound and B-lines quantification inaccuracy: B sure to have the right solution

Lung Ultrasound: The Emerging Role of Respiratory Therapists

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