Lung ultrasound findings in patients with novel SARS-CoV-2
| Autor: | David J. van Westerloo, Mark A. van de Wiel, Micah L. A. Heldeweg, Jasper M. Smit, Jip S. Nooitgedacht, Carlos V. Elzo Kraemer, Jessica D. van Trigt, Jorge E. Lopez Matta, Pieter R. Tuinman, Mark E. Haaksma, Armand R. J. Girbes, Leo M. A. Heunks |
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| Přispěvatelé: | Intensive care medicine, Anesthesiology, Epidemiology and Data Science, APH - Methodology, ACS - Diabetes & metabolism, AII - Infectious diseases, ACS - Pulmonary hypertension & thrombosis |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Pleural effusion Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lcsh:Medicine 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences 0302 clinical medicine law Medicine Pathological Lung business.industry lcsh:R Ultrasound 030208 emergency & critical care medicine respiratory system medicine.disease Intensive care unit Lung ultrasound respiratory tract diseases Pneumonia medicine.anatomical_structure Original Article Radiology business |
| Zdroj: | ERJ Open Research, 6(4). EUROPEAN RESPIRATORY SOC JOURNALS LTD ERJ Open Research article-version (AM) Accepted Manuscript ERJ Open Research, Vol 6, Iss 4 (2020) Haaksma, M E, Heldeweg, M L A, Lopez Matta, J E, Smit, J M, van Trigt, J D, Nooitgedacht, J S, Elzo Kraemer, C V, van de Wiel, M, Girbes, A R J, Heunks, L, van Westerloo, D J & Tuinman, P R 2020, ' Lung ultrasound findings in patients with novel SARS-CoV-2 ', BMJ Open, vol. 6, no. 4 . https://doi.org/10.1183/23120541.00238-2020 BMJ Open, 6(4). BMJ Publishing Group |
| ISSN: | 2312-0541 |
| DOI: | 10.1183/23120541.00238-2020 |
| Popis: | BackgroundOver 2 million people worldwide have been infected with severe acute respiratory distress syndrome-coronavirus-2 (SARS CoV-2). Lung ultrasound has been proposed to diagnose and monitor it, despite the fact that little is known about the ultrasound appearance due to the novelty of the illness. The aim of this manuscript is to characterise the lung ultrasonographic appearance of critically ill patients with SARS-CoV-2 pneumonia, with particular emphasis on its relationship with the time course of the illness and clinical parameters.MethodsAdult patients from the intensive care unit of two academic hospitals who tested positive for SARS-CoV-2 were included. Images were analysed using internationally recognised techniques which included assessment of the pleura, number of B-lines, pathology in the PLAPS (posterolateral alveolar and/or pleural syndrome) point, bedside lung ultrasound in emergency profiles, and the lung ultrasound score. The primary outcomes were frequencies, percentages and differences in lung ultrasound findings overall and between short (≤14 days) and long (>14 days) durations of symptoms and their correlation with clinical parameters.ResultsIn this pilot observational study, 61 patients were included with 76 examinations available for analysis. 26% of patients had no anterior lung abnormalities, while the most prevalent pathological ultrasound findings were thickening of the pleura (42%), ≥3 B-lines per view (38%) and presence of PLAPS (74%). Patients with “long” duration of symptoms presented more frequently with a thickened and irregular pleura (32 (21%) versus 11 (9%)), C-profile (18 (47%) versus 8 (25%)) and pleural effusion (14 (19%) versus 3 (5%)), compared to patients with short duration of symptoms. Lung ultrasound findings did not correlate with arterial oxygen tension/inspiratory oxygen fraction ratio, fluid balance or dynamic compliance.ConclusionSARS-CoV-2 results in significant, but not specific, ultrasound changes, with decreased lung sliding, thickening of the pleura and a B-profile being the most commonly observed. With time, a thickened and irregular pleura, C-profile and pleural effusion become more common findings. When screening patients, a comprehensive ultrasound protocol might be necessary. |
| Databáze: | OpenAIRE |
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