Ultrasound versus Computed Tomography Assessment of Focal Lung Aeration in Invasively Ventilated ICU Patients.

Autor:	Smit MR; Department of Intensive Care, Amsterdam UMC, location AMC, Amsterdam, The Netherlands; Technical Medicine Centre, University of Twente, Enschede, The Netherlands. Electronic address: m.r.smit@amsterdamumc.nl., Pisani L; Department of Intensive Care, Amsterdam UMC, location AMC, Amsterdam, The Netherlands; Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand., de Bock EJE; Department of Intensive Care, Amsterdam UMC, location AMC, Amsterdam, The Netherlands; Technical Medicine Centre, University of Twente, Enschede, The Netherlands., van der Heijden F; Technical Medicine Centre, University of Twente, Enschede, The Netherlands; Department of Robotics and Mechatronics, University of Twente, Enschede, The Netherlands., Paulus F; Department of Intensive Care, Amsterdam UMC, location AMC, Amsterdam, The Netherlands., Beenen LFM; Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands., Leopold SJ; Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand; Department of Internal Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands., Huson MAM; Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands., Henwood PC; Emergency Medicine Department, Brigham and Women's Hospital, Boston, Massachusetts, USA., Riviello ED; Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA., Walden AP; Department of ICU, Royal Berkshire Hospital, Reading, United Kingdom., Dondorp AM; Department of Intensive Care, Amsterdam UMC, location AMC, Amsterdam, The Netherlands; Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand., Schultz MJ; Department of Intensive Care, Amsterdam UMC, location AMC, Amsterdam, The Netherlands; Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand; Nuffield Department of Medicine, University of Oxford, Headington, Oxford, United Kingdom., Bos LDJ; Department of Intensive Care, Amsterdam UMC, location AMC, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Ultrasound in medicine & biology [Ultrasound Med Biol] 2021 Sep; Vol. 47 (9), pp. 2589-2597. Date of Electronic Publication: 2021 Jun 23.
DOI:	10.1016/j.ultrasmedbio.2021.05.019
Abstrakt:	It is unknown whether and to what extent the penetration depth of lung ultrasound (LUS) influences the accuracy of LUS findings. The current study evaluated and compared the LUS aeration score and two frequently used B-line scores with focal lung aeration assessed by chest computed tomography (CT) at different levels of depth in invasively ventilated intensive care unit (ICU) patients. In this prospective observational study, patients with a clinical indication for chest CT underwent a 12-region LUS examination shortly before CT scanning. LUS images were compared with corresponding regions on the chest CT scan at different subpleural depths. For each LUS image, the LUS aeration score was calculated. LUS images with B-lines were scored as the number of separately spaced B-lines (B-line count score) and the percentage of the screen covered by B-lines divided by 10 (B-line percentage score). The fixed-effect correlation coefficient (β) was presented per 100 Hounsfield units. A total of 40 patients were included, and 372 regions were analyzed. The best association between the LUS aeration score and CT was found at a subpleural depth of 5 cm for all LUS patterns (β = 0.30, p < 0.001), 1 cm for A- and B1-patterns (β = 0.10, p < 0.001), 6 cm for B1- and B2-patterns (β = 0.11, p < 0.001) and 4 cm for B2- and C-patterns (β = 0.07, p = 0.001). The B-line percentage score was associated with CT (β = 0.46, p = 0.001), while the B-line count score was not (β = 0.07, p = 0.305). In conclusion, the subpleural penetration depth of ultrasound increased with decreased aeration reflected by the LUS pattern. The LUS aeration score and the B-line percentage score accurately reflect lung aeration in ICU patients, but should be interpreted while accounting for the subpleural penetration depth of ultrasound. (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu