Lung Ultrasound for Detection of Pulmonary Complications in Critically Ill Obstetric Patients in a Resource-Limited Setting

Pisani, Luigi; Nicolo, Anna De; Schiavone, Marcella; Adeniji, Adetunji Oladeni; Palma, Angela De; Gennaro, Francesco Di; Emuveyan, Edward E.; Grasso, Salvatore; Henwood, Patricia C.; Koroma, Alimamy P.; Leopold, Stije J.; Marotta, Claudia; Marulli, Giuseppe; Putoto, Giovanni; Pisani, Enzo; Russel, James; Neto, Ary Serpa; Dondorp, Arjen M.; Hanciles, Eva; Koroma, Michael M.; Schultz, Marcus J.

doi:10.4269/ajtmh.20-0996

Cited by 16 publications

(25 citation statements)

References 35 publications

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“…We analyzed 171 LUS reports from 21 ICUs. The number of LUS examinations performed by each ICU during the index week, expressed as a mean and an interquartile range, was 8 [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. The main characteristics of the enrolled patients are shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Thoracic UltrasONOgraphy Reporting: The TUONO Study

Calamai

Greco

Finazzi

et al. 2022

JCM

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Lung ultrasound (LUS) is a validated technique for the prompt diagnosis and bedside monitoring of critically ill patients due to its availability, safety profile, and cost-effectiveness. The aim of this work is to detect similarities and differences among LUS reports performed in ICUs and to provide a common ground for an integrated report form. We collected all LUS reports during an index week in 21 ICUs from the GiViTI network. First, we considered signs, chest areas, and terminology reported. Then, we compared different report structures and categorized them as structured reports (SRs), provided with a predefined model form, and free unstructured text reports (FTRs) that had no predetermined structure. We analyzed 171 reports from 21 ICUs, and 59 reports from 5 ICUs were structured. All the reports presented a qualitative description that mainly focused on the presence of B-lines, consolidations, and pleural effusion. Zones were defined in 66 reports (39%). In SRs, a complete examination of all the regions was more frequently achieved (96% vs. 74%), and a higher impact on therapeutic strategies was observed (17% vs. 6%). LUS reports vary significantly among different centers. Adopting an integrated SR seems to promote a systematic approach in scanning and reporting, with a potential impact on LUS clinical applications.

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Section: Resultsmentioning

confidence: 99%

Thoracic UltrasONOgraphy Reporting: The TUONO Study

Calamai

Greco

Finazzi

et al. 2022

JCM

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“…For example, previously implemented LUS methods with comparable complexity were reproducible between operators after limited training ( Bouhemad et al, 2010 ; Mongodi et al, 2017 ; Rouby et al, 2018 ; Vercesi et al, 2018 ). Moreover, LUS is one of the tools that is also suitable for diagnosis and management of ARDS patients in limited resource settings ( Riviello et al, 2016 ; Pisani et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Lung Ultrasound Assessment of Focal and Non-focal Lung Morphology in Patients With Acute Respiratory Distress Syndrome

et al. 2021

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Background: The identification of phenotypes based on lung morphology can be helpful to better target mechanical ventilation of individual patients with acute respiratory distress syndrome (ARDS). We aimed to assess the accuracy of lung ultrasound (LUS) methods for classification of lung morphology in critically ill ARDS patients under mechanical ventilation.Methods: This was a post hoc analysis on two prospective studies that performed LUS and chest computed tomography (CT) scanning at the same time. Expert panels from the two participating centers separately developed two LUS methods for classifying lung morphology based on LUS aeration scores from a 12-region exam (Amsterdam and Lombardy method). Moreover, a previously developed LUS method based on anterior LUS scores was tested (Piedmont method). Sensitivity and specificity of all three LUS methods was assessed in the cohort of the other center(s) by using CT as the gold standard for classification of lung morphology.Results: The Amsterdam and Lombardy cohorts consisted of 32 and 19 ARDS patients, respectively. From these patients, 23 (45%) had focal lung morphology while others had non-focal lung morphology. The Amsterdam method could classify focal lung morphology with a sensitivity of 77% and a specificity of 100%, while the Lombardy method had a sensitivity and specificity of 100 and 61%. The Piedmont method had a sensitivity and specificity of 91 and 75% when tested on both cohorts. With both the Amsterdam and Lombardy method, most patients could be classified based on the anterior regions alone.Conclusion: LUS-based methods can accurately classify lung morphology in invasively ventilated ARDS patients compared to gold standard chest CT. The anterior LUS regions showed to be the most discriminant between focal and non-focal lung morphology, although accuracy increased moderately when lateral and posterior LUS regions were integrated in the method.

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“…These simple bedside tools could be useful in resource-limited settings, and outside the traditional intensive care unit. [26][27][28] Evidence from retrospective analysis supports the ability of the SpO 2 /FiO 2 ratio to predict outcomes in patients with ARDS. 26 In resource-limited settings, in which mechanical ventilation, blood gas analysis, and chest imaging might not be available, the Kigali modification using the SpO 2 /FiO 2 ratio and lung ultrasound has been suggested and has been useful to evaluate ARDS.…”

Section: Diagnosismentioning

confidence: 96%