Concise Versus Extended Lung Ultrasound Score to Monitor Critically Ill Patients With COVID-19.

Autor:	Heldeweg M; Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands; and Amsterdam Leiden IC Focused Echography, Amsterdam, the Netherlands. M.heldeweg@amsterdamumc.nl., Lieveld AW; Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands; and Section Acute Medicine, Department of Internal Medicine, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands., Walburgh-Schmidt RS; Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands., Smit JM; Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands; and Section Acute Medicine, Department of Internal Medicine, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands., Haaksma ME; Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands; and Amsterdam Leiden IC Focused Echography, Amsterdam, the Netherlands., Veldhuis L; Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands., de Grooth HJ; Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands., Girbes AR; Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands., Heunks LM; Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands., Tuinman PR; Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands; and Amsterdam Leiden IC Focused Echography, Amsterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	Respiratory care [Respir Care] 2023 Mar; Vol. 68 (3), pp. 400-407. Date of Electronic Publication: 2023 Jan 17.
DOI:	10.4187/respcare.10406
Abstrakt:	Background: Lung ultrasound (LUS) can be used to monitor critically ill patients with COVID-19, but the optimal number of examined lung zones is disputed. Methods: This was a prospective observational study. The objective was to investigate whether concise (6 zones) and extended (12 zones) LUS scoring protocols are clinically equivalent in critically ill ICU subjects with COVID-19. The primary outcome of this study was (statistical) agreement between concise and extended LUS score index evaluated in both supine and prone position. Agreement was determined using correlation coefficients and Bland-Altman plots to detect systematic differences between protocols. Secondary outcomes were difference between LUS score index in supine and prone position using similar methods. Results: We included 130 LUS examinations in 40 subjects (mean age 69.0 ± 8.5y, 75% male). Agreement between concise and extended LUS score index had no clinically relevant constant or proportional bias and limits of agreement were below the smallest detectable change. Across position changes, supine LUS score index was 8% higher than prone LUS score index and had limits above the smallest detectable change, indicating true LUS score index differences between protocols may occur due to the position change itself. Lastly, inter-rater and intra-rater agreement were very good. Conclusions: Concise LUS was equally informative as extended LUS for monitoring critically ill subjects with COVID-19 in supine or prone position. Clinicians can monitor patients undergoing position changes but must be wary that LUS score index alterations may result from the position change itself rather than disease progression or clinical improvement. Competing Interests: The authors have disclosed no conflicts of interest. (Copyright © 2023 by Daedalus Enterprises.)
Databáze:	MEDLINE
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