Lung ultrasound score as a tool to monitor disease progression and detect ventilator-associated pneumonia during COVID-19-associated ARDS

•Lung ultrasound score (LUS) is negatively correlated to PaO2/FIO2.•LUS increases over time in non-survivors, whereas it decreases in survivors.•LUS increases significantly during ventilatory associated pneumonia (VAP) episodes. Lung ultrasound can accurately detect pandemic coronavirus disease (COV...

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Bibliographic Details
Published in:Heart & lung 2021-09, Vol.50 (5), p.700-705
Main Authors: Dargent, Auguste, Chatelain, Emeric, Si-Mohamed, Salim, Simon, Marie, Baudry, Thomas, Kreitmann, Louis, Quenot, Jean-Pierre, Cour, Martin, Argaud, Laurent
Format: Article
Language:English
Subjects:
ARDS
COVID-19
Critical care
Disease Progression
Humans
Life Sciences
Lung - diagnostic imaging
Pneumonia
Pneumonia, Ventilator-Associated - diagnosis
Reproducibility of Results
Respiratory Distress Syndrome - diagnosis
Respiratory Distress Syndrome - etiology
SARS-CoV-2
Ultrasonography
Ventilator-associated pneumonia
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Summary:•Lung ultrasound score (LUS) is negatively correlated to PaO2/FIO2.•LUS increases over time in non-survivors, whereas it decreases in survivors.•LUS increases significantly during ventilatory associated pneumonia (VAP) episodes. Lung ultrasound can accurately detect pandemic coronavirus disease (COVID-19) pulmonary lesions. A lung ultrasound score (LUS) was developed to improve reproducibility of the technique. To evaluate the clinical value of LUS monitoring to guide COVID-19-associated acute respiratory distress syndrome (ARDS) management. We conducted a single center, prospective observational study, including all patients admitted with COVID-19-associated ARDS between March and April 2020. A systematic daily LUS evaluation was performed. Thirty-three consecutive patients were included. LUS was significantly and negatively correlated to PaO2/FIO2. LUS increased significantly over time in non-survivors compared to survivors. LUS increased in 83% of ventilatory associated pneumonia (VAP) episodes, when compared to the previous LUS evaluation. LUS was not significantly higher in patients presenting post-extubation respiratory failure. In conclusion, our study demonstrates that LUS variations are correlated to disease severity and progression, and LUS monitoring could contribute to the early diagnosis of VAPs.
ISSN:0147-9563
1527-3288
DOI:10.1016/j.hrtlng.2021.05.003