Anesthesiology, Department of Medicine and Surgery, Critical Care and Pain Medicine Division, University of Parma, Viale Gramsci 14, 43126, Parma, Italy.
Anesthesiology and Critical Care Division, Azienda Ospedaliero-Universitaria Di Parma, Parma, Italy.
J Clin Monit Comput. 2022 Jun;36(3):785-793. doi: 10.1007/s10877-021-00709-w. Epub 2021 May 4.
Lung ultrasound is a well-established diagnostic tool in acute respiratory failure, and it has been shown to be particularly suited for the management of COVID-19-associated respiratory failure. We present exploratory analyses on the diagnostic and prognostic performance of lung ultrasound score (LUS) in general ward patients with moderate-to-severe COVID-19 pneumonia receiving O supplementation and/or noninvasive ventilation. From March 10 through May 1, 2020, 103 lung ultrasound exams were performed by our Forward Intensive Care Team (FICT) on 26 patients (18 males and 8 females), aged 62 (54 - 76) and with a Body Mass Index (BMI) of 30.9 (28.7 - 31.5), a median 6 (5 - 9) days after admission to the COVID-19 medical unit of the University Hospital of Parma, Italy. All patients underwent chest computed tomography (CT) the day of admission. The initial LUS was 16 (11 - 21), which did not significantly correlate with initial CT scans, probably due to rapid progression of the disease and time between CT scan on admission and first FICT evaluation; conversely, LUS was significantly correlated with PaO/FiO ratio throughout patient follow-up [R = - 4.82 (- 6.84 to - 2.80; p < 0.001)]. The area under the receiving operating characteristics curve of LUS for the diagnosis of moderate-severe disease (PaO/FiO ratio ≤ 200 mmHg) was 0.73, with an optimal cutoff value of 11 (positive predictive value: 0.98; negative predictive value: 0.29). Patients who eventually needed invasive ventilation and/or died during admission had significantly higher LUS throughout their stay.
肺部超声在急性呼吸衰竭中是一种成熟的诊断工具，并且已经证明它特别适用于 COVID-19 相关呼吸衰竭的管理。我们对接受氧气补充和/或无创通气的中度至重度 COVID-19 肺炎普通病房患者的肺部超声评分（LUS）的诊断和预后性能进行了探索性分析。从 2020 年 3 月 10 日至 5 月 1 日，我们的前方重症监护团队（FICT）对 26 名患者（18 名男性和 8 名女性）进行了 103 次肺部超声检查，年龄为 62（54-76），体重指数（BMI）为 30.9（28.7-31.5），中位数为 6（5-9）天入住意大利帕尔马大学医院的 COVID-19 医疗单位。所有患者入院当天均接受了胸部计算机断层扫描（CT）。初始 LUS 为 16（11-21），与初始 CT 扫描无显著相关性，可能是由于疾病的快速进展和入院时 CT 扫描与首次 FICT 评估之间的时间间隔；相反，LUS 与患者随访期间的 PaO/FiO 比值显著相关[R=−4.82（−6.84 至−2.80；p<0.001)]。LUS 用于诊断中度至重度疾病（PaO/FiO 比值≤200mmHg）的接受者工作特征曲线下面积为 0.73，最佳截断值为 11（阳性预测值：0.98；阴性预测值：0.29）。在住院期间最终需要有创通气和/或死亡的患者，其 LUS 始终较高。
