scholarly journals Lung ultrasound may be a valuable aid in decision making for patients admitted with COVID-19 disease

2021 ◽  
Vol 8 (1) ◽  
pp. 1909521
Author(s):  
Casper Falster ◽  
Niels Jacobsen ◽  
Lone Wulff Madsen ◽  
Line Dahlerup Rasmussen ◽  
Jesper Rømhild Davidsen ◽  
...  
Keyword(s):  
Decision Making ◽  
Lung Ultrasound

scholarly journals Can Alveolar-Arterial Difference and Lung Ultrasound Help the Clinical Decision Making in Patients with COVID-19?

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 761
Author(s):  
Gianmarco Secco ◽  
Francesco Salinaro ◽  
Carlo Bellazzi ◽  
Marco La Salvia ◽  
Marzia Delorenzo ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Signs And Symptoms ◽  
Clinical Decision ◽  
Arterial Oxygen ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Lung Dysfunction ◽  
Close Relationship

Background: COVID-19 is an emerging infectious disease, that is heavily challenging health systems worldwide. Admission Arterial Blood Gas (ABG) and Lung Ultrasound (LUS) can be of great help in clinical decision making, especially during the current pandemic and the consequent overcrowding of the Emergency Department (ED). The aim of the study was to demonstrate the capability of alveolar-to-arterial oxygen difference (AaDO2) in predicting the need for subsequent oxygen support and survival in patients with COVID-19 infection, especially in the presence of baseline normal PaO2/FiO2 ratio (P/F) values. Methods: A cohort of 223 swab-confirmed COVID-19 patients underwent clinical evaluation, blood tests, ABG and LUS in the ED. LUS score was derived from 12 ultrasound lung windows. AaDO2 was derived as AaDO2 = ((FiO2) (Atmospheric pressure − H2O pressure) − (PaCO2/R)) − PaO2. Endpoints were subsequent oxygen support need and survival. Results: A close relationship between AaDO2 and P/F and between AaDO2 and LUS score was observed (R2 = 0.88 and R2 = 0.67, respectively; p < 0.001 for both). In the subgroup of patients with P/F between 300 and 400, 94.7% (n = 107) had high AaDO2 values, and 51.4% (n = 55) received oxygen support, with 2 ICU admissions and 10 deaths. According to ROC analysis, AaDO2 > 39.4 had 83.6% sensitivity and 90.5% specificity (AUC 0.936; p < 0.001) in predicting subsequent oxygen support, whereas a LUS score > 6 showed 89.7% sensitivity and 75.0% specificity (AUC 0.896; p < 0.001). Kaplan–Meier curves showed different mortality in the AaDO2 subgroups (p = 0.0025). Conclusions: LUS and AaDO2 are easy and effective tools, which allow bedside risk stratification in patients with COVID-19, especially when P/F values, signs, and symptoms are not indicative of severe lung dysfunction.

Impact of lung ultrasound on clinical decision making in critically ill patients

2013 ◽  
Vol 40 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Nektaria Xirouchaki ◽  
Eumorfia Kondili ◽  
George Prinianakis ◽  
Polychronis Malliotakis ◽  
Dimitrios Georgopoulos
Keyword(s):  
Decision Making ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Clinical Decision

scholarly journals COVID-19 or not COVID-19, that is the question. The role of screening criteria and point-of-care lung ultrasound in the triage decision-making process in an Emergency Department during the phase 2 of the COVID-19 Italian epidemic

2021 ◽  
Vol 17 (2) ◽  
Author(s):  
Erika Poggiali ◽  
Davide Bastoni ◽  
Mariachiara Ferrari ◽  
Dario Moretto ◽  
Federico Buttafava ◽  
...  
Keyword(s):  
Decision Making ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Decision Making Process ◽  
Phase 2 ◽  
Screening Criteria ◽  
Triage Decision ◽  
Clean Area ◽  
Real Challenge

In the COVID-19 era the real challenge for the Emergency Departments (ED) is to avoid the spread of the viral infection within the so called “clean area” of the emergency room and the hospital. Different protocols have been proposed and adopted in the EDs to quickly identify suspected COVID-19 patients and to correctly manage these patients, all based on clinical and epidemiological criteria. To the best of our knowledge, our pre-triage decisional making-process first integrates the pre-triage interview with pointof- care Lung Ultrasound (LUS) performed in the triage area. The aim of our study is to assess the sensitivity and specificity of our screening clinical and/or epidemiological criteria, and to investigate the role of LUS in the triage decision-making process during the “phase 2” of the COVID-19 Italian epidemic. Our study confirms the pivotal role of the triage in the decision-making process and the management of the entire ED, and it demonstrates that further studies are necessary to validate the role of LUS as tool to promptly identify COVID-19 patients, if combined with a correct pre-triage interview.

I-AIM (Indication, Acquisition, Interpretation, Medical Decision-making) Framework for Point of Care Lung Ultrasound

2017 ◽  
Vol 127 (3) ◽  
pp. 568-582 ◽  
Author(s):  
Richelle Kruisselbrink ◽  
Vincent Chan ◽  
Gian Alfonso Cibinel ◽  
Simon Abrahamson ◽  
Alberto Goffi
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Comprehensive Approach ◽  
Medical Decision ◽  
Digital Content ◽  
Point Of Care Ultrasound ◽  
Ultrasound Application ◽  
Decision Making Model

The I-AIM (Indication, Acquisition, Interpretation, Medical decision-making) model is a conceptive framework uniquely applicable to every point of care ultrasound application. We present a systematic comprehensive approach to lung ultrasound based on the I-AIM framework. Supplemental Digital Content is available in the text.

scholarly journals Lung ultrasound may be a valuable aid in decision making for patients admitted with COVID-19 disease

2021 ◽  
Author(s):  
Casper Falster ◽  
Niels Jacobsen ◽  
Lone Wolff Madsen ◽  
Line Dahlerup Rasmussen ◽  
Jesper Rømhild Davidsen ◽  
...  
Keyword(s):  
Decision Making ◽  
Lung Ultrasound

scholarly journals The impact of lung ultrasound on clinical-decision making across departments: a systematic review

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Micah L. A. Heldeweg ◽  
Lian Vermue ◽  
Max Kant ◽  
Michelle Brouwer ◽  
Armand R. J. Girbes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Clinical Decision ◽  
Current Evidence ◽  
Substantial Impact ◽  
Thoracic Ultrasound ◽  
Newcastle Ottawa Scale ◽  
The Impact

Abstract Background Lung ultrasound has established itself as an accurate diagnostic tool in different clinical settings. However, its effects on clinical-decision making are insufficiently described. This systematic review aims to investigate the impact of lung ultrasound, exclusively or as part of an integrated thoracic ultrasound examination, on clinical-decision making in different departments, especially the emergency department (ED), intensive care unit (ICU), and general ward (GW). Methods This systematic review was registered at PROSPERO (CRD42021242977). PubMed, EMBASE, and Web of Science were searched for original studies reporting changes in clinical-decision making (e.g. diagnosis, management, or therapy) after using lung ultrasound. Inclusion criteria were a recorded change of management (in percentage of cases) and with a clinical presentation to the ED, ICU, or GW. Studies were excluded if examinations were beyond the scope of thoracic ultrasound or to guide procedures. Mean changes with range (%) in clinical-decision making were reported. Methodological data on lung ultrasound were also collected. Study quality was scored using the Newcastle–Ottawa scale. Results A total of 13 studies were included: five studies on the ED (546 patients), five studies on the ICU (504 patients), two studies on the GW (1150 patients), and one study across all three wards (41 patients). Lung ultrasound changed the diagnosis in mean 33% (15–44%) and 44% (34–58%) of patients in the ED and ICU, respectively. Lung ultrasound changed the management in mean 48% (20–80%), 42% (30–68%) and 48% (48–48%) of patients in the ED, in the ICU and in the GW, respectively. Changes in management were non-invasive in 92% and 51% of patients in the ED and ICU, respectively. Lung ultrasound methodology was heterogeneous across studies. Risk of bias was moderate to high in all studies. Conclusions Lung ultrasound, exclusively or as a part of thoracic ultrasound, has substantial impact on clinical-decision making by changing diagnosis and management in the EDs, ICUs, and GWs. The current evidence level and methodological heterogeneity underline the necessity for well-designed trials and standardization of methodology.

Use And Influence Of Lung Ultrasound On Clinical Decision Making In Critically Ill Patients

2010 ◽  
Author(s):  
Nektaria Xirouchaki ◽  
Maria Plataki ◽  
DHMHTRHS BABALIS ◽  
LEFTERIS MAGKANAS ◽  
VAGGELIS KANIARIS ◽  
...  
Keyword(s):  
Decision Making ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Clinical Decision

POCUS for pleural assessment and intervention

POCUS Journal ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 4-5
Author(s):  
Nicholas Grubic, BScH ◽  
Barry Chan, MD
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Diagnostic Accuracy ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Clinical Decision

The use of point-of-care thoracic (lung) ultrasound is an integral part of clinical practice that has shown diagnostic accuracy to help guide clinical decision making for pleural interventions.

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