Details

Autor(en) / Beteiligte

• Costamagna, Andrea
• Pivetta, Emanuele
• Goffi, Alberto
• Steinberg, Irene
• Arina, Pietro
• Mazzeo, Anna Teresa
• Del Sorbo, Lorenzo
• Veglia, Simona
• Davini, Ottavio
• Brazzi, Luca
• Ranieri, V. Marco
• Fanelli, Vito

Titel

Clinical performance of lung ultrasound in predicting ARDS morphology

Ist Teil von

• Annals of intensive care, 2021-03, Vol.11 (1), p.51-51, Article 51

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2021

Link zum Volltext

Quelle

SpringerLink (Online service)

Beschreibungen/Notizen

• Background To assess diagnostic performance of lung ultrasound (LUS) in identifying ARDS morphology (focal vs non-focal), compared with the gold standard computed tomography. Methods Mechanically ventilated ARDS patients undergoing lung computed tomography and ultrasound were enrolled. Twelve fields, were evaluated. LUS score was graded from 0 (normal) to 3 (consolidation) according to B-lines extent. Total and regional LUS score as the sum of the four ventral (LUS V ), intermediate (LUS I ) or dorsal (LUS D ) fields, were calculated. Based on lung CT, ARDS morphology was defined as (1) focal (loss of aeration with lobar distribution); (2) non-focal (widespread loss of aeration or segmental loss of aeration distribution associated with uneven lung attenuation areas), and diagnostic accuracy of LUS in discriminating ARDS morphology was determined by AU-ROC in training and validation set of patients. Results Forty-seven patients with ARDS (25 training set and 22 validation set) were enrolled. LUS TOT , LUS V and LUS I but not LUS D score were significantly lower in focal than in non-focal ARDS morphologies ( p  < .01). The AU-ROC curve of LUS TOT , LUS V , LUS I and LUS D for identification of non-focal ARDS morphology were 0.890, 0.958, 0.884 and 0.421, respectively. LUS V value ≥ 3 had the best predictive value (sensitivity = 0.95, specificity = 1.00) in identifying non-focal ARDS morphology. In the validation set, an LUS V score ≥ 3 confirmed to be highly predictive of non-focal ARDS morphology, with a sensitivity and a specificity of 94% and 100%. Conclusions LUS had a valuable performance in distinguishing ARDS morphology.