Lung Ultrasound for Imaging of B-Lines in Dogs and Cats—A Prospective Study Investigating Agreement between Three Types of Transducers and the Accuracy in Diagnosing Cardiogenic Pulmonary Edema, Pneumonia and Lung Neoplasia

Transthoracic heart and lung ultrasound (LUS) was performed in 200 dogs and cats with dyspnea to evaluate the agreement between the results obtained using three types of transducers (microconvex, linear, and phased array) and to determine the accuracy of LUS in discriminating between three conditions commonly causing dyspnea in companion animals: cardiogenic pulmonary edema (CPE), pneumonia, and lung neoplasm. The agreement beyond chance was assessed using the weighted Cohen’s kappa coefficient (κw). The highest values of κw (>0.9) were observed for the pair of microconvex and linear transducers. To quantify B-lines the lung ultrasound score (LUSscore) was developed as a sum of points describing the occurrence of B-lines for each of 8 standardized thoracic locations. The accuracy of LUSscore was determined using the area under ROC curve (AUROC). In dogs AUROC of LUSscore was 75.9% (CI 95%: 65.0% to 86.8%) for distinguishing between lung neoplasms and the two other causes of dyspnea. In cats AUROC of LUSscore was 83.6% (CI 95%: 75.2% to 92.0%) for distinguishing between CPE and the two other causes of dyspnea. The study shows that results obtained with microconvex and linear transducers are highly consistent and these two transducers can be used interchangeably. Moreover, the LUSscore may help identify dogs with lung neoplasms and cats with CPE, however its diagnostic accuracy is only fair to moderate.

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Comparison of lung bedside ultrasound and BNP in the diagnosis of acute heart failure in the emergency department

Journal of Research in Clinical Medicine ◽

10.34172/jrcm.2020.050 ◽

2020 ◽

Vol 8 (1) ◽

pp. 50-50

Author(s):

Seyed Hossein Ojaghi Haghighi ◽

Neda Hamed ◽

Shiva Ebrahimi ◽

Jafar Ghobadi ◽

Hoorolnesa Ameli

Keyword(s):

Heart Failure ◽

Emergency Room ◽

Pulmonary Edema ◽

Acute Heart Failure ◽

Lung Ultrasound ◽

P Value ◽

Ultrasound Evaluation ◽

Ultrasound Findings ◽

Medical Advances ◽

B Lines

Introduction: Congestive heart failure is heart muscle failure that causes pulmonary congestion and eventually pulmonary edema, which despite recent medical advances, is still a progressive syndrome with high mortality, the prevalence of which has increased in recent decades. Therefore, in this study we compared lung ultrasound findings in acute heart failure patients with the BNP. Methods: This study was performed in the emergency room of Imam Reza hospital in Tabriz. For patients entering the emergency room after taking a history, both standard gold (BNP) tests and beside ultrasound of the lung were performed. Ultrasound was performed at the same time as obtaining blood sample to ensure that the ultrasound specialist did not know the result of diagnosis. During the ultrasound, if there were multiple B-Lines that were at least 3 mm apart, patient was diagnosed with pulmonary edema due to heart failure. Results: Number of participants in this study was 108 people, 54.6% of whom were men and the rest were women. The correlation coefficient between width and number of kerley lines was 0.79, between NT-pro BNP and width of kerley lines was 0.65 and between NT-pro BNP and number of kerley lines was 0.77, which indicates a significant positive correlation (P value <0.001). Conclusion: The results of present study showed that in patients with acute heart failure, the number and width of kerley lines in pulmonary ultrasound evaluation increase rapidly. There is also a high correlation between number and length of kerley lines with NT-pro BNP serum values.

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Lung ultrasound is useful in oncohematologic patients with respiratory dysfunction admitted to an Intensive Care Unit (ICU): a pilot study

Medical Ultrasonography ◽

10.11152/mu-2332 ◽

2020 ◽

Vol 22 (2) ◽

pp. 1780182

Author(s):

Cecilia Gomez Ravetti ◽

Thiago Braganca Lana Silveira Ataide ◽

Lidia Miranda Barreto ◽

Fabricio De Lima Bastos ◽

Angelica Gomide dos Reis Gomes ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pilot Study ◽

Lung Ultrasound ◽

Respiratory Dysfunction ◽

Icu Admission ◽

Immunosuppressed Patients ◽

Show Difference ◽

Ultrasound Score ◽

B Lines

Aims: This pilot study aimed to evaluate the usefulness of a sequential lung ultrasound score (LUS) in immunosuppressed patients with oncohematologic diseases and acute respiratory dysfunction hospitalized in an intensive care unit (ICU).Materials and methods: LUS was calculated at ICU admission, after 24 h, 48 h and at discharge. A score ranging from 0 to 26 was attributed according to the number of B lines, presence of lung consolidation and pleural effusion.Results: Twenty-six patients were included. The median age was 50 years [interquartile range (IQR) 21] and 14 (54%) were male. LUS on the day of ICU admission was significantly higher in non-survivors compared to survivors (13 [5] vs 9 [9], respectively; p=0.047). The median delta LUS (LUS_D2 – LUS_D1) did not show difference between survivors and non-survivors (2 [0-7.5] vs 1 [-1.5 – 5], p=0.33). Among patients initially submitted to noninvasive mechanical ventilation (NIMV), no difference in LUS at inclusion or after 24 h was found between those who succeeded or failed on this support.Conclusion: The use of LUS to quantify lung aeration loss in oncohematologic patients hospitalized in an ICU due to acute respiratory dysfunction might be a helpful tool to predict the severity of the illness.

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Point-of-Care Lung Ultrasound for COVID-19: Findings and Prognostic Implications From 105 Consecutive Patients

Journal of Intensive Care Medicine ◽

10.1177/0885066620988831 ◽

2021 ◽

Vol 36 (3) ◽

pp. 334-342 ◽

Cited By ~ 1

Author(s):

Kosuke Yasukawa ◽

Taro Minami ◽

David R. Boulware ◽

Ayako Shimada ◽

Ernest A. Fischer

Keyword(s):

Negative Predictive Value ◽

Predictive Value ◽

Prognostic Value ◽

Lung Ultrasound ◽

Point Of Care ◽

Respiratory Support ◽

Point Of Care Ultrasound ◽

Bilateral Involvement ◽

Ultrasound Score ◽

B Lines

Background: The prognostic value of point-of-care lung ultrasound has not been evaluated in a large cohort of patients with COVID-19 admitted to general medicine ward in the United States. The aim of this study was to describe lung ultrasound findings and their prognostic value in patients with COVID-19 admitted to internal medicine ward. Method: This prospective observational study consecutively enrolled 105 hospitalized participants with COVID-19 at 2 tertiary care centers. Ultrasound was performed in 12 lung zones within 24 hours of admission. Findings were assessed relative to 4 outcomes: intensive care unit (ICU) need, need for intensive respiratory support, length of stay, and death. Results: We detected abnormalities in 92% (97/105) of participants. The common findings were confluent B-lines (92%), non-homogenous pleural lines (78%), and consolidations (54%). Large confluent B-lines, consolidations, bilateral involvement, and any abnormality in ≥ 6 areas were associated with a longer hospitalization and need for intensive respiratory support. Large confluent B-lines and bilateral involvement were also associated with ICU stay. A total lung ultrasound score <5 had a negative predictive value of 100% for the need of intensive respiratory support. A higher total lung ultrasound score was associated with ICU need (median total 18 in the ICU group vs. 11 non-ICU, p = 0.004), a hospitalization ≥ 9d (15 vs 10, p = 0.016) and need for intensive respiratory support (18 vs. 8.5, P < 0.001). Conclusions: Most patients hospitalized with COVID-19 had lung ultrasound abnormalities on admission and a higher lung ultrasound score was associated with worse clinical outcomes except death. A low total lung ultrasound score (<5) had a negative predictive value of 100% for the need of intensive respiratory support. Point-of-care ultrasound can aid in the risk stratification for patients with COVID-19 admitted to general wards.

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Utility of point‐of‐care lung ultrasound for monitoring cardiogenic pulmonary edema in dogs

Journal of Veterinary Internal Medicine ◽

10.1111/jvim.15990 ◽

2020 ◽

Author(s):

Shane D. Murphy ◽

Jessica L. Ward ◽

Austin K. Viall ◽

Melissa A. Tropf ◽

Rebecca L. Walton ◽

...

Keyword(s):

Pulmonary Edema ◽

Lung Ultrasound ◽

Point Of Care ◽

Cardiogenic Pulmonary Edema

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THE IDEAL PROFILE (INCREASE IN B-LINES/DELTA B-LINES) ON LUNG ULTRASOUND FOR DIAGNOSING WEANING INDUCED PULMONARY EDEMA IN VENTILATED PATIENTS

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i6.5691 ◽

2022 ◽

Vol 71 (6) ◽

pp. 2220-23

Author(s):

Ghulam Rasheed ◽

Zahid Siddique Shad ◽

Tooba Mehreen ◽

Nusrat Kharadi ◽

Moazma Ramzan ◽

...

Keyword(s):

Mechanical Ventilation ◽

Pulmonary Edema ◽

Spontaneous Breathing ◽

Lung Ultrasound ◽

Weaning Failure ◽

Before And After ◽

Spontaneous Breathing Trials ◽

B Lines ◽

Ventilated Patients ◽

The Ideal

Objective: To ascertain the ideal number of B-lines on lung ultrasound for the diagnosis of weaning induced pulmonary edema in ventilated patients. Study Design: Prospective observational study. Place and Duration of Study: Department of Medicine, Shifa International Hospital, Islamabad, from Jan to Aug 2020. Methodology: All the patients over the age of 18 years who were on mechanical ventilation in a medical intensive care unit were included in the study. The patients were given spontaneous breathing trials as a protocol for weaning from mechanical ventilation. Lung ultrasound was performed on 4 points of anterior chest wall before and after spontaneous breathing trials. Before and after spontaneous breathing trials counting of B lines was done on ultrasound of lung and comparison of increase in B lines (Delta-B-lines) was done with reference diagnosis of weaning induced pulmonary edema diagnosed by intensivist who was blinded to the results of lung ultrasound. Results: The study included 42 patients including 23 (54.8%) men and 19 (45.2%) women. 14 cases failed spontaneous breathing trials. Seven cases (16.7%) had weaning induced pulmonary edema. Delta-B-lines ≥6 diagnosed weaning induced pulmonary edema with 100% accuracy. Out of the remaining seven patients with weaning failure but without weaning induced pulmonary edema, 6 (28.6%) had Delta-B-lines ≥6. The ultrasound lung technique had a 100% sensitivity profile to detect weaning induced pulmonary edema and a specificity of 77.78%. Conclusion: The study indicates that Delta-B-lines ≥6 diagnosed the weaning induced pulmonary edema with the best accuracy.

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Lung Ultrasound Score Assessing the Pulmonary Edema in Pediatric Acute Respiratory Distress Syndrome Received Continuous Hemofiltration Therapy: A Prospective Observational Study

10.21203/rs.3.rs-31702/v1 ◽

2020 ◽

Author(s):

Fei Wang ◽

Chunxia Wang ◽

Jingyi Shi ◽

Yijun Shan ◽

Huijie Miao ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Renal Replacement Therapy ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Continuous Renal Replacement Therapy ◽

Pulmonary Edema ◽

Replacement Therapy ◽

Distress Syndrome ◽

Lung Ultrasound ◽

Ultrasound Score

Abstract Background: Lung ultrasound score is a potential method for determining pulmonary edema in acute respiratory distress syndrome. Continuous renal replacement therapy has become the preferred modality to manage fluid overload during acute respiratory distress syndrome. The aim of this study was to evaluate the value of lung ultrasound score on assessing the effects of continuous renal replacement therapy on pulmonary edema and pulmonary function in pediatric acute respiratory distress syndrome. Methods: We conducted a prospective study in children with moderate to severe acute respiratory distress syndrome in a tertiary university pediatric intensive care unit from January 2016 to December 2018. Lung ultrasound score was measured within 2 hours identified acute respiratory distress syndrome as the value of 1st，and the following three days as the 2nd, 3rd, and 4th.Results: A total of 70 patients with acute respiratory distress syndrome were enrolled in this study. Thirty-seven patients received continuous renal replacement therapy (CRRT group) and thirty-three patients treated by conventional therapy (Non-CRRT group). The 1st lung ultrasound score in CRRT group were significantly higher than Non-CRRT group (P < 0.05), but the lung ultrasound score decreased gradually following the continuous renal replacement therapy (P < 0.001). Lung ultrasound score was significantly correlated with PaO2/FiO2, dynamic lung compliance, and oxygen index based on 1st to 4th values (all P<0.001). Lung ultrasound score decreased from 22 (18 - 25) to 15 (13 - 18) and PaO2/FiO2 promoted from 106.00 (96.00 - 121.50) mmHg to 160.00 (142.50 - 173.00) mmHg after continuous renal replacement therapy for four days (both P < 0.001).Conclusions: Lung ultrasound score is closely correlated with PaO2/FiO2, oxygen index and dynamic lung compliance in pediatric acute respiratory distress syndrome. The improvement of pulmonary edema in patient with acute respiratory distress syndrome received continuous renal replacement therapy can be assessed by the lung ultrasound score.Trial registration: CCTR, ChiCTR-ONC-16009698. Registered 1 November 2016, prospectively registered, http://www.chictr.org.cn/edit.aspx?pid=16535&htm=4. This study adheres to CONSORT guidelines.

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Lung ultrasound score assessing the pulmonary edema in pediatric acute respiratory distress syndrome received continuous hemofiltration therapy: A prospective observational study

10.21203/rs.3.rs-31702/v2 ◽

2020 ◽

Author(s):

Fei Wang ◽

Chunxia Wang ◽

Jingyi Shi ◽

Yijun Shan ◽

Huijie Miao ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Pulmonary Edema ◽

Distress Syndrome ◽

Lung Ultrasound ◽

Potential Method ◽

Lung Compliance ◽

Continuous Hemofiltration ◽

Ultrasound Score

Abstract Background: Lung ultrasound score is a potential method for determining pulmonary edema in acute respiratory distress syndrome (ARDS). Continuous renal replacement therapy (CRRT) has become the preferred modality to manage fluid overload during ARDS. The aim of this study was to evaluate the value of lung ultrasound (LUS) score on assessing the effects of CRRT on pulmonary edema and pulmonary function in pediatric ARDS. Methods: We conducted a prospective cohort study in 70 children with moderate to severe ARDS in a tertiary university pediatric intensive care unit from January 2016 to December 2018. 37 patients received CRRT (CRRT group) and 33 patients treated by conventional therapy (Non-CRRT group). LUS score was measured within 2 hours identified ARDS as the value of 1st，and the following three days as the 2nd, 3rd, and 4th. We used Spearman correlation analysis to develop the relationship between LUS score and PaO2/FiO2, dynamic lung compliance (Cdyn), PaCO2, oxygen index (OI), as well as between the change in daily fluid balance volume and the change in LUS score during CRRT.Results: The 1st lung ultrasound score in CRRT group were significantly higher than Non-CRRT group (P < 0.001), but the lung ultrasound score decreased gradually following CRRT (P < 0.001). LUS score was significantly correlated with PaO2/FiO2 (1st: r =-0.800, 2nd: r =-0.807, 3rd: r =-0.703, 4th: r =-0.584), Cdyn (1st: r =-0.757, 2nd: r =-0.906, 3rd: r =-0.885, 4th: r =-0.834), and OI (1st: r =0.678, 2nd: r =0.689, 3rd: r =0.486, 4th: r =0.324) based on 1st to 4th values (all P<0.05). LUS score decreased from 22 (18 - 25) to 15 (13 - 18) and PaO2/FiO2 promoted from 106.00 (96.00 - 121.50) mmHg to 160.00 (142.50 - 173.00) mmHg after CRRT for four days (both P < 0.001).Conclusions: LUS score is significantly correlated with lung function parameters in pediatric ARDS. The improvement of pulmonary edema in patient with ARDS received CRRT can be assessed by the LUS score.

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TRANSTHORACIC LUNG ULTRASOUND IN NORMAL DOGS AND DOGS WITH CARDIOGENIC PULMONARY EDEMA: A PILOT STUDY

Veterinary Radiology & Ultrasound ◽

10.1111/vru.12151 ◽

2014 ◽

Vol 55 (4) ◽

pp. 447-452 ◽

Cited By ~ 27

Author(s):

Nathalie Rademacher ◽

Romain Pariaut ◽

Julie Pate ◽

Carley Saelinger ◽

Michael T. Kearney ◽

...

Keyword(s):

Pilot Study ◽

Pulmonary Edema ◽

Lung Ultrasound ◽

Cardiogenic Pulmonary Edema

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Usefulness of lung ultrasound in the early identification of severe COVID-19: results from a prospective study

Medical Ultrasonography ◽

10.11152/mu-3263 ◽

2021 ◽

Author(s):

Alba Hernández-Píriz ◽

Yale Tung-Chen ◽

David Jiménez-Virumbrales ◽

Ibone Ayala-Larrañaga ◽

Raquel Barba-Martín ◽

...

Keyword(s):

Respiratory Failure ◽

Lung Ultrasound ◽

Invasive Mechanical Ventilation ◽

Inverse Correlation ◽

Kappa Index ◽

Ultrasound Findings ◽

High Concordance ◽

Ultrasound Score ◽

A Prospective Study ◽

Prospective Longitudinal

Aim: There is growing evidence regarding the imaging findings of coronavirus disease 2019 (COVID-19) in lung ultrasound (LUS); however, its role in predicting the prognosis has yet to be explored. The aim of the study was to assess the relationship between lung ultrasound findings with the degree of respiratory failure measured by the PaO2/FiO2 ratio (PaFi) andthe prognosis of these patients: need for non-invasive mechanical ventilation (NIMV), admission to the Intensive Care Unit (ICU) and mortality.Material and method: Prospective, longitudinal and observational study performed in patients with confirmed COVID-19 underwent a LUS examination and laboratory tests.Results: A total of 107 patients were enrolled: 93.4% with bilateral involvement and 73.83% presented at least one consolidation. A good inverse correlation (Rho Spearman coefficient -0.897) between the ultrasound score and PaFi was obtained. The AUC for identification of patients with more severe respiratory failure, a moderate and severe ARDS, was 0.97 (CI 95%: 0.95-1) and a cut-off score of 34.5 showed a sensitivity of 0.94 and a specificity of 0.91. The Kappa index showed a high concordance (0.83) of the classification by ultrasound lunginvolvement and ARDS.Conclusions: The combination of the ultrasound score and the presence of respiratory failure can easily identify patients with a higher risk to present complications.

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