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Lung ultrasound predicts clinical course but not outcome in COVID-19 ICU patients: a retrospective single-center analysis.
Stecher, Stephanie-Susanne; Anton, Sofia; Fraccaroli, Alessia; Götschke, Jeremias; Stemmler, Hans Joachim; Barnikel, Michaela.
  • Stecher SS; Medical Department II, LMU Hospital Munich, Marchioninistr. 15, 81377, Munich, Germany. StephanieSusanne.Stecher@med.uni-muenchen.de.
  • Anton S; Medical Department II, LMU Hospital Munich, Marchioninistr. 15, 81377, Munich, Germany.
  • Fraccaroli A; Medical Department III, LMU Hospital Munich, Marchioninistr. 15, 81377, Munich, Germany.
  • Götschke J; Medical Department V, LMU Hospital Munich, Marchioninistr. 15, 81377, Munich, Germany.
  • Stemmler HJ; Medical Department III, LMU Hospital Munich, Marchioninistr. 15, 81377, Munich, Germany.
  • Barnikel M; Medical Department V, LMU Hospital Munich, Marchioninistr. 15, 81377, Munich, Germany.
BMC Anesthesiol ; 21(1): 178, 2021 06 28.
Article in English | MEDLINE | ID: covidwho-1286811
ABSTRACT

BACKGROUND:

Point-of-care lung ultrasound (LU) is an established tool in the first assessment of patients with coronavirus disease (COVID-19). Purpose of this study was to evaluate the value of lung ultrasound in COVID-19 intensive care unit (ICU) patients in predicting clinical course and outcome.

METHODS:

We analyzed lung ultrasound score (LUS) of all COVID-19 patients admitted from March 2020 to December 2020 to the Internal Intensive Care Unit, Ludwig-Maximilians-University (LMU) of Munich. LU was performed according to a standardized protocol at ICU admission and in case of clinical deterioration with the need for intubation. A normal lung scores 0 points, the worst LUS has 24 points. Patients were stratified in a low (0-12 points) and a high (13-24 points) lung ultrasound score group.

RESULTS:

The study included 42 patients, 69% of them male. The most common comorbidities were hypertension (81%) and obesity (57%). The values of pH (7.42 ± 0.09 vs 7.35 ± 0.1; p = 0.047) and paO2 (107 [80-130] vs 80 [66-93] mmHg; p = 0.034) were significantly reduced in patients of the high LUS group. Furthermore, the duration of ventilation (12.5 [8.3-25] vs 36.5 [9.8-70] days; p = 0.029) was significantly prolonged in this group. Patchy subpleural thickening (n = 38; 90.5%) and subpleural consolidations (n = 23; 54.8%) were present in most patients. Pleural effusion was rare (n = 4; 9.5%). The median total LUS was 11.9 ± 3.9 points. In case of clinical deterioration with the need for intubation, LUS worsened significantly compared to baseline LU. Twelve patients died during the ICU stay (29%). There was no difference in survival in both LUS groups (75% vs 66.7%, p = 0.559).

CONCLUSIONS:

LU can be a useful monitoring tool to predict clinical course but not outcome of COVID-19 ICU patients and can early recognize possible deteriorations.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Ultrasonography / Critical Care / SARS-CoV-2 / COVID-19 / Lung Subject: Ultrasonography / Critical Care / SARS-CoV-2 / COVID-19 / Lung Type of study: Diagnostic study / Clinical Practice Guide / Observational study / Prognostic study / Risk factors Language: English Journal: BMC Anesthesiol Clinical aspect: Diagnosis / Prediction / Prognosis Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Ultrasonography / Critical Care / SARS-CoV-2 / COVID-19 / Lung Subject: Ultrasonography / Critical Care / SARS-CoV-2 / COVID-19 / Lung Type of study: Diagnostic study / Clinical Practice Guide / Observational study / Prognostic study / Risk factors Language: English Journal: BMC Anesthesiol Clinical aspect: Diagnosis / Prediction / Prognosis Year: 2021
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