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Lung ultrasound score to monitor COVID-19 pneumonia progression in patients with ARDS.
PLoS One. 2020; 15(7):e0236312.Plos

Abstract

COVID-19 pneumonia typically begins with subpleural ground glass opacities with progressive extension on computerized tomography studies. Lung ultrasound is well suited to this interstitial, subpleural involvement, and it is now broadly used in intensive care units (ICUs). The extension and severity of lung infiltrates can be described numerically with a reproducible and validated lung ultrasound score (LUSS). We hypothesized that LUSS might be useful as a tool to non-invasively monitor the evolution of COVID-19 pneumonia at the bedside. LUSS monitoring was rapidly implemented in the management of our COVID-19 patients with RT-PCR-documented COVID-19. The LUSS was evaluated repeatedly at the bedside. We present a graphic description of the course of LUSS during COVID-19 in 10 consecutive patients admitted in our intensive care unit with moderate to severe ARDS between March 15 and 30th. LUSS appeared to be closely related to the disease progression. In successfully extubated patients, LUSS decreased and was lower than at the time of intubation. LUSS increased inexorably in a patient who died from refractory hypoxemia. LUSS helped with the diagnosis of ventilator-associated pneumonia (VAP), showing an increased score and the presence of new lung consolidations in all 5 patients with VAPs. There was also a good agreement between CT-scans and LUSS as for the presence of lung consolidations. In conclusion, our early experience suggests that LUSS monitoring accurately reflect disease progression and indicates potential usefulness for the management of COVID-19 patients with ARDS. It might help with early VAP diagnosis, mechanical ventilation weaning management, and potentially reduce the need for X-ray and CT exams. LUSS evaluation is easy to use and readily available in ICUs throughout the world, and might be a safe, cheap and simple tool to optimize critically ill COVID-19 patients care during the pandemic.

Authors+Show Affiliations

Service de Médecine Intensive-Réanimation Médicale, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France.Service de Médecine Intensive-Réanimation Médicale, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France.Service de Médecine Intensive-Réanimation Médicale, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France. Faculté de médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France.Médecine Intensive Réanimation, CHU Dijon, Dijon, France. Université Bourgogne Franche-Comté, LNC, Dijon, France. INSERM, LNC UMR1231, Dijon, France. FCS Bourgogne-Franche Comté, LipSTIC LabEx, Dijon, France.Service de Médecine Intensive-Réanimation Médicale, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France. Faculté de médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France.Service de Médecine Intensive-Réanimation Médicale, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France. Faculté de médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32692769

Citation

Dargent, Auguste, et al. "Lung Ultrasound Score to Monitor COVID-19 Pneumonia Progression in Patients With ARDS." PloS One, vol. 15, no. 7, 2020, pp. e0236312.
Dargent A, Chatelain E, Kreitmann L, et al. Lung ultrasound score to monitor COVID-19 pneumonia progression in patients with ARDS. PLoS One. 2020;15(7):e0236312.
Dargent, A., Chatelain, E., Kreitmann, L., Quenot, J. P., Cour, M., & Argaud, L. (2020). Lung ultrasound score to monitor COVID-19 pneumonia progression in patients with ARDS. PloS One, 15(7), e0236312. https://doi.org/10.1371/journal.pone.0236312
Dargent A, et al. Lung Ultrasound Score to Monitor COVID-19 Pneumonia Progression in Patients With ARDS. PLoS One. 2020;15(7):e0236312. PubMed PMID: 32692769.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lung ultrasound score to monitor COVID-19 pneumonia progression in patients with ARDS. AU - Dargent,Auguste, AU - Chatelain,Emeric, AU - Kreitmann,Louis, AU - Quenot,Jean-Pierre, AU - Cour,Martin, AU - Argaud,Laurent, AU - ,, Y1 - 2020/07/21/ PY - 2020/05/17/received PY - 2020/07/04/accepted PY - 2020/7/22/entrez PY - 2020/7/22/pubmed PY - 2020/8/4/medline SP - e0236312 EP - e0236312 JF - PloS one JO - PLoS One VL - 15 IS - 7 N2 - COVID-19 pneumonia typically begins with subpleural ground glass opacities with progressive extension on computerized tomography studies. Lung ultrasound is well suited to this interstitial, subpleural involvement, and it is now broadly used in intensive care units (ICUs). The extension and severity of lung infiltrates can be described numerically with a reproducible and validated lung ultrasound score (LUSS). We hypothesized that LUSS might be useful as a tool to non-invasively monitor the evolution of COVID-19 pneumonia at the bedside. LUSS monitoring was rapidly implemented in the management of our COVID-19 patients with RT-PCR-documented COVID-19. The LUSS was evaluated repeatedly at the bedside. We present a graphic description of the course of LUSS during COVID-19 in 10 consecutive patients admitted in our intensive care unit with moderate to severe ARDS between March 15 and 30th. LUSS appeared to be closely related to the disease progression. In successfully extubated patients, LUSS decreased and was lower than at the time of intubation. LUSS increased inexorably in a patient who died from refractory hypoxemia. LUSS helped with the diagnosis of ventilator-associated pneumonia (VAP), showing an increased score and the presence of new lung consolidations in all 5 patients with VAPs. There was also a good agreement between CT-scans and LUSS as for the presence of lung consolidations. In conclusion, our early experience suggests that LUSS monitoring accurately reflect disease progression and indicates potential usefulness for the management of COVID-19 patients with ARDS. It might help with early VAP diagnosis, mechanical ventilation weaning management, and potentially reduce the need for X-ray and CT exams. LUSS evaluation is easy to use and readily available in ICUs throughout the world, and might be a safe, cheap and simple tool to optimize critically ill COVID-19 patients care during the pandemic. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/32692769/Lung_ultrasound_score_to_monitor_COVID_19_pneumonia_progression_in_patients_with_ARDS_ L2 - https://dx.plos.org/10.1371/journal.pone.0236312 DB - PRIME DP - Unbound Medicine ER -