肺部超声可能是入院的COVID-19疾病患者决策的有价值的帮助。

IF 1.8 Q3 RESPIRATORY SYSTEM European Clinical Respiratory Journal Pub Date : 2021-04-07 DOI:10.1080/20018525.2021.1909521
Casper Falster, Niels Jacobsen, Lone Wulff Madsen, Line Dahlerup Rasmussen, Jesper Rømhild Davidsen, Fredrikke Christie Knudtzen, Stig Lønberg Nielsen, Isik Somuncu Johansen, Christian B Laursen
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引用次数: 10

摘要

导论:COVID-19与严重肺炎和急性呼吸窘迫综合征(ARDS)的风险相关,需要在重症监护病房(ICU)进行治疗。由于临床恶化可能会迅速发生,因此需要一种简单、快速、床边、无创的方法来评估肺部变化。本研究的主要目的是调查入院72小时内肺部超声(LUS)检查结果是否可预测确诊为SARS-CoV-2的住院患者的临床恶化。方法:入住专门的COVID-19病房的患者接受每日LUS检查。记录实变和胸腔积液的数量,并计算蒙古分数。这些发现与最初的胸部x线检查和临床恶化(定义为icu入院、ARDS诊断、死亡)相关。结果:83例患者中29例在入院时行LUS, 18例在入院后72小时内行LUS。其中,4例患者在入院期间死亡,6例转至ICU, 13例被诊断为ARDS。初始蒙古评分在有无临床恶化的患者之间无显著差异(p = 0.95)。最初的LUS和胸部x线检查结果一致,Cohen的Kappa值为0.21。结论:入住专用COVID-19病房的患者在72小时内进行的LUS不能预测ARDS、ICU入院或死亡。然而,连续的调查可能是有价值的,因为突然的实质性变化可能预示着疾病的进展,从而能够更早地进行补充诊断和开始治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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

INTRODUCTION: COVID-19 is associated with a risk of severe pneumonia and acute respiratory distress syndrome (ARDS), requiring treatment at an intensive care unit (ICU). Since clinical deterioration may occur rapidly, a simple, fast, bedside, non-invasive method for assessment of lung changes is warranted. The primary aim of this study was to investigate whether lung ultrasound (LUS) findings within 72 hours of admission were predictive of clinical deterioration in hospitalized patients with confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). METHODS: Patients admitted to a dedicated COVID-19 unit were subject to daily LUS examinations. Number of present consolidations and pleural effusions were registered and a Mongodi score was calculated. These findings were correlated with initial chest x-ray and clinical deterioration, defined as ICU-admission, ARDS diagnosis, death. RESULTS: In total, 29 of 83 patients had LUS performed during admission, 18 within 72 h of admission. Of these, four patients died during admission, six were transferred to the ICU and 13 were diagnosed with ARDS. Initial Mongodi-score did not differ significantly between patients with and without clinical deterioration (p = 0.95). Agreement between initial LUS and chest x-ray findings were fair with Cohen's Kappa at 0.21. CONCLUSION: LUS performed within 72 h in patients admitted to a dedicated COVID-19 unit could not predict ARDS, ICU admission or death. However, consecutive investigations may be of value, as sudden substantial changes may herald disease progression, enabling earlier supplementary diagnostics and treatment initiation.

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CiteScore
3.80
自引率
0.00%
发文量
15
审稿时长
16 weeks
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