Early detection of acute lung injury uncoupled to hypoxemia in pigs using ultrasound lung comets*

Gargani, Luna; Lionetti, Vincenzo; Cristofano, Claudio Di; Bevilacqua, Generoso; Recchia, Fabio A.; Picaño, Eugenio

doi:10.1097/01.ccm.0000287525.03140.3f

Cited by 126 publications

(99 citation statements)

References 29 publications

(21 reference statements)

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“…There are no previous studies comparing lung US and LC in humans. In pigs a significant increase in B-lines in US and a significant reduction in LC was observed 15 min after oleic acid-induced lung injury [23]. However, the correlation between US and LC was not reported in the study.…”

Section: Discussionmentioning

confidence: 53%

Lung Ultrasound and Static Lung Compliance during Postnatal Adaptation in Healthy Term Infants

et al. 2015

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Background: B-lines in lung ultrasound can be used to estimate lung liquid. B-lines are ring-down artifacts that arise from alterations to subpleural lung parenchyma. Lung ultrasound has been used to differentiate between diseases causing respiratory symptoms in neonates. B-lines are also seen in healthy infants during postnatal adaptation. Static lung compliance is a measure of the elasticity of the lungs. Objectives: Our aim was to document lung ultrasound findings, static lung compliance and their relationship during postnatal adaptation in healthy term infants. Methods: Lung ultrasound and measurement of static lung compliance were performed in 34 infants at ages of 0-4 and 24 h. B-lines in lung ultrasound were scored using a 5-step scale. Separate ultrasound scores for the upper and lower fields were also calculated. Results: A significant decrease in the abundance of B-lines and a concomitant significant improvement in static lung compliance was observed from <4 to 24 h of age. At <4 h the B-lines were significantly more abundant in the lower fields. No significant correlation existed between lung ultrasound and static lung compliance. Conclusion: The concomitant decrease in the B-lines in ultrasound and the increase in lung compliance during the first 24 h are likely to reflect clearance of lung liquid.

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Section: Discussionmentioning

confidence: 53%

Lung Ultrasound and Static Lung Compliance during Postnatal Adaptation in Healthy Term Infants

et al. 2015

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“…ULC are a very sensitive but not specific sign of HF-related pulmonary congestion: being a sign of thickened interlobular septa, ULC may be present in ARDS [37] and pulmonary fibrosis [34]. Cardiogenic watery ULC can be hardly distinguished from pneumogenic fibrotic ULC, which can be found in pulmonay fibrosis, although cardiogenic ULC are more numerous in the dependent zones of the lungs, and can be dissolved in a few hours by an acute diuretic load [34].…”

Section: Midaxillarymentioning

confidence: 98%

“…5). Recently, ULC method has been applied to a pig model of oleic-acid induced lung injury, which mimics human Acute Respiratory Distress Syndrome (ARDS) [37]. ULC unmasked accumulation of histological verified extravascular lung water very early in the course of lung injury in pigs, even at a stage when no changes in hemogasanalysis parameters could be observed.…”

Section: Midclavearmentioning

confidence: 99%

Why, when, and how to assess pulmonary congestion in heart failure: pathophysiological, clinical, and methodological implications

2009

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Acute heart failure syndrome (AHFS) is a major public health problem. It is defined as gradual or rapid change in heart failure (HF) signs and symptoms, which often results in an unplanned hospitalization and a need for urgent therapy. Many evidence-based pharmacologic, device, and surgical treatment for HF are available or under development. Despite these new treatments and improvement in survival, hospitalizations in HF have steadily increased over the last 30 years, and the post-discharge prognosis of patients hospitalized with AHFS remains poor (Gheorghiade et al. Circulation 112:3958-3968, 2005; Fonarow et al. Rev Cardiovasc Med 4:S21-30, 2003). Most hospitalizations for AHFS are related to "congestion" rather than to low cardiac output. The definition, identification, quantification, and monitoring of congestion are therefore essential in AHFS. The purpose of this article is: (1) to characterize the different types of hemodynamic, clinical, and pulmonary congestion in AHFS; (2) to focus on the different possible ways to assess pulmonary congestion (probably the most important, and up to now the most diagnostically elusive of the three types of congestions); (3) to propose new possible ways to implement objective and user-friendly measures of pulmonary congestion in clinical and scientific decision-making in AHFS in the near future.

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“…2). Sonographic abnormalities precede Pa O 2 /Fi O 2 changes [6,20] and, unlike CXR, sonographic appearance of RDS does not change immediately after surfactant administration. This may be related to the immaturity of the interstitial space that is not affected by the exogenous surfactant administration.…”

Section: Discussionmentioning

confidence: 99%

Lung Ultrasound Accuracy in Respiratory Distress Syndrome and Transient Tachypnea of the Newborn

et al. 2014

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Background: Lung ultrasound (LUS) is a promising technique for the diagnosis of neonatal respiratory diseases. Preliminary data has shown a good sensitivity and specificity of LUS in the diagnosis of respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN). Objective: The aim of this study was to calculate the sensitivity, specificity, and negative (NPV) and positive predictive value (PPV) of LUS for RDS and TTN, using an external reader blinded to the clinical condition. Design and Methods: Neonates with respiratory distress had a LUS within 1 h of admission. Images were uploaded and sent to the external reader, who made the ultrasound diagnosis according to the appearance of the images. The final clinical diagnosis was made according to all the available data, except LUS data. Sensitivity, specificity, PPV, and NPV were calculated considering the final clinical diagnosis as the gold standard. Results: Fifty-nine neonates were studied (mean gestational age: 33 ± 4 weeks, mean birth weight: 2,145 ± 757 g). Twenty-three infants had a final diagnosis of RDS and 30 of TTN. LUS showed a sensitivity of 95.6% and specificity of 94.4%, with a PPV of 91.6% and a NPV of 97.1% for RDS, and a sensitivity of 93.3% and specificity of 96.5% with a PPV of 96.5% and a NPV of 93.4% for TTN. Conclusions: LUS showed high sensitivity and specificity in diagnosing RDS and TTN.

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Early detection of acute lung injury uncoupled to hypoxemia in pigs using ultrasound lung comets*

Cited by 126 publications

References 29 publications

Lung Ultrasound and Static Lung Compliance during Postnatal Adaptation in Healthy Term Infants

Lung Ultrasound and Static Lung Compliance during Postnatal Adaptation in Healthy Term Infants

Why, when, and how to assess pulmonary congestion in heart failure: pathophysiological, clinical, and methodological implications

Lung Ultrasound Accuracy in Respiratory Distress Syndrome and Transient Tachypnea of the Newborn

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