CHEST Guidelines-Validation-of-New-Quantitative-Lung-Ultrasound-Pro

Validation-of-New-Quantitative-Lung-Ultrasound-Pro

Pdf Summary

The study by Micah L. A. Heldeweg and colleagues examines the effectiveness of two lung ultrasound protocols, LUS and LUSext, in assessing lung involvement in COVID-19 patients. LUSext, a novel protocol, is compared with the more established lung ultrasound score (LUS). The study aims to validate LUSext and assess its correlation with clinical outcomes and CT severity scores (CTSS) in both emergency department (ED) and intensive care unit (ICU) settings.<br /><br />Conducted as a post hoc analysis of four prospective studies at Amsterdam University Medical Center, the research includes 282 lung ultrasound examinations of COVID-19 patients. Results showed that both LUS and LUSext have a positive correlation with CTSS and ventilator-free days at 90 days. The correlation was stronger in LUS, particularly in ICU settings, suggesting LUSext may not sufficiently differentiate the extent of lung injury.<br /><br />While LUSext provides a practical and rapid assessment in the ED by focusing on the overall extent of lung affliction, it might not be as beneficial in ICU settings due to its tendency to mask specific pathological patterns of lung involvement. On the other hand, LUS evaluates both the extent and specific patterns but requires greater expertise and pattern recognition skills.<br /><br />The authors conclude that LUSext is a valuable tool for quick evaluations in emergency settings, but LUS remains the more comprehensive choice for ICUs, especially in patients with severe or global pulmonary afflictions. The study acknowledges limitations in the methodology and the need for further research to determine the clinical utility of LUSext. The findings underline the importance of selecting appropriate ultrasound protocols according to the clinical setting and patient needs.

Keywords

lung ultrasound

LUS

LUSext

COVID-19

CT severity scores

emergency department

intensive care unit

ventilator-free days

pulmonary afflictions

clinical outcomes