Validation of New Quantitative Lung Ultrasound Protocol and Comparison With Lung Ultrasound Score in Patients With COVID-19

Pisani, Luigi; Heldeweg, Micah L A; Lieveld, Arthur W.E.; Haaksma, Mark E.; Smit, Jeff M.; Mousa, Amne; Klompmaker, Peter; Smit, Marry R.; Bos, Lieuwe; Matta, Jorge E. López; Kraemer, Carlos V. Elzo; Westerloo, David J. van; Tuinman, Pieter R.

doi:10.1016/j.chest.2023.07.022

CHEST

2023

DOI: 10.1016/j.chest.2023.07.022

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Validation of New Quantitative Lung Ultrasound Protocol and Comparison With Lung Ultrasound Score in Patients With COVID-19

Luigi Pisani¹,

Micah L A Heldeweg²,

Arthur W.E. Lieveld³

et al.

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2024

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Lung ultrasound score for the assessment of lung aeration in ARDS patients: comparison of two approaches

Mongodi,

Chiumello,

Mojoli

2024

Ultrasound Int Open

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Purpose A 4-step lung ultrasound (LUS) score has been previously used to quantify lung density. We compared 2 versions of this scoring system for distinguishing severe from moderate loss of aeration in ARDS: coalescence-based score (cLUS) vs. quantitative-based score (qLUS – >50% pleura occupied by artefacts). Materials and Methods We compared qLUS and cLUS to lung density measured by quantitative CT scan in 12 standard thoracic regions. A simplified approach (1 scan per region) was compared to an extensive one (regional score computed as the mean of all relevant intercostal space scores). Results We examined 13 conditions in 7 ARDS patients (7 at PEEP 5, 6 at PEEP 15 cmH2O-156 regions, 398 clips). Switching from cLUS to qLUS resulted in a change in interpretation in 117 clips (29.4%, 1-point reduction) and in 41.7% of the regions (64 decreases (range 0.2–1), 1 increase (0.2 points)). Regional qLUS showed very strong correlation with lung density (rs=0.85), higher than cLUS (rs=0.79; p=0.010). The agreement with CT classification in well aerated, poorly aerated, and not aerated tissue was moderate for cLUS (agreement 65.4%; Cohen’s K coefficient 0.475 (95%CI 0.391–0.547); p<0.0001) and substantial for qLUS (agreement 81.4%; Cohen’s K coefficient 0.701 (95%CI 0.653–0.765), p<0.0001). The agreement between single spot and extensive approaches was almost perfect (cLUS: agreement 89.1%, Cohen’s kappa coefficient 0.840 (95%CI 0.811–0.911), p<0.0001; qLUS: agreement 86.5%, Cohen’s kappa coefficient 0.819 (95%CI 0.761–0.848), p<0.0001). Conclusion A LUS score based on the percentage of occupied pleura performs better than a coalescence-based approach for quantifying lung density. A simplified approach performs as well as an extensive one.

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Lung ultrasound score for the assessment of lung aeration in ARDS patients: comparison of two approaches

Mongodi,

Chiumello,

Mojoli

2024

Ultrasound Int Open

View full text Add to dashboard Cite

show abstract

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Validation of New Quantitative Lung Ultrasound Protocol and Comparison With Lung Ultrasound Score in Patients With COVID-19

Cited by 1 publication

References 12 publications

Lung ultrasound score for the assessment of lung aeration in ARDS patients: comparison of two approaches

Lung ultrasound score for the assessment of lung aeration in ARDS patients: comparison of two approaches

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