Operative Research Unit of Internal Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128, Rome, Italy.
Department of Medicine and Surgery, Research Unit of Geriatrics, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy.
Aging Clin Exp Res. 2023 Dec;35(12):2887-2901. doi: 10.1007/s40520-023-02590-w. Epub 2023 Nov 11.
This paper reports the proceedings of a meeting convened by the Research Group on Thoracic Ultrasound in Older People of the Italian Society of Gerontology and Geriatrics, to discuss the current state-of-the-art of clinical research in the field of geriatric thoracic ultrasound and identify unmet research needs and potential areas of development. In the last decade, point-of-care thoracic ultrasound has entered clinical practice for diagnosis and management of several respiratory illnesses, such as bacterial and viral pneumonia, pleural effusion, acute heart failure, and pneumothorax, especially in the emergency-urgency setting. Very few studies, however, have been specifically focused on older patients with frailty and multi-morbidity, who frequently exhibit complex clinical pictures needing multidimensional evaluation. At the present state of knowledge, there is still uncertainty on the best requirements of ultrasound equipment, methodology of examination, and reporting needed to optimize the advantages of thoracic ultrasound implementation in the care of geriatric patients. Other issues regard differential diagnosis between bacterial and aspiration pneumonia, objective grading of interstitial syndrome severity, quantification and monitoring of pleural effusions and solid pleural lesions, significance of ultrasonographic assessment of post-COVID-19 sequelae, and prognostic value of assessment of diaphragmatic thickness and motility. Finally, application of remote ultrasound diagnostics in the community and nursing home setting is still poorly investigated by the current literature. Overall, the presence of several open questions on geriatric applications of thoracic ultrasound represents a strong call to implement clinical research in this field.
本文报告了意大利老年病学和老年医学学会胸超声研究小组召开的一次会议的会议记录，旨在讨论老年胸超声领域临床研究的现状，确定未满足的研究需求和潜在的发展领域。在过去的十年中，床边胸超声已进入临床实践，用于诊断和治疗多种呼吸系统疾病，如细菌性和病毒性肺炎、胸腔积液、急性心力衰竭和气胸，尤其是在紧急情况下。然而，很少有研究专门针对虚弱和多病共存的老年患者，这些患者经常表现出需要多维评估的复杂临床情况。在目前的知识状态下，对于优化胸超声在老年患者护理中的应用所需的超声设备、检查方法和报告的最佳要求仍存在不确定性。其他问题包括细菌性和吸入性肺炎的鉴别诊断、间质性综合征严重程度的客观分级、胸腔积液和实体胸膜病变的定量和监测、COVID-19 后遗症的超声评估意义以及膈肌厚度和运动的评估预后价值。最后，远程超声诊断在社区和疗养院环境中的应用在当前文献中仍未得到充分研究。总的来说，胸超声在老年病学中的应用存在几个悬而未决的问题，这强烈呼吁在该领域开展临床研究。
