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Lung Ultrasound in Patients with Acute Respiratory Failure Reduces Conventional Imaging and Health Care Provider Exposure to COVID-19.
Ultrasound in Medicine & Biology ( IF 2.9 ) Pub Date : 2020-05-06 , DOI: 10.1016/j.ultrasmedbio.2020.04.033
Silvia Mongodi 1 , Anita Orlando 1 , Eric Arisi 1 , Guido Tavazzi 2 , Erminio Santangelo 3 , Luca Caneva 1 , Marco Pozzi 1 , Eleonora Pariani 4 , Giada Bettini 4 , Giuseppe Maggio 1 , Stefano Perlini 5 , Lorenzo Preda 6 , Giorgio Antonio Iotti 2 , Francesco Mojoli 2
Affiliation  

Lung ultrasound gained a leading position in the last year as an imaging technique for the assessment and management of patients with acute respiratory failure. In coronavirus disease 2019 (COVID-19), its role may be of further importance because it is performed bedside and may limit chest X-ray and the need for transport to radiology for computed tomography (CT) scan. Since February 21, we progressively turned into a coronavirus-dedicated intensive care unit and applied an ultrasound-based approach to avoid traditional imaging and limit contamination as much as possible. We performed a complete daily examination with lung ultrasound score computation and systematic search of complications (pneumothorax, ventilator-associated pneumonia); on-duty physicians were free to perform CT or chest X-ray when deemed indicated. We compared conventional imaging exams performed in the first 4 wk of the COVID-19 epidemic with those in the same time frame in 2019: there were 84 patients in 2020 and 112 in 2019; 64 and 22 (76.2% vs. 19.6%, p < 0.001) had acute respiratory failure, respectively, of which 55 (85.9%) were COVID-19 in 2020. When COVID-19 patients in 2020 were compared with acute respiratory failure patients in 2019, the median number of chest X-rays was 1.0 (1.0–2.0) versus 3.0 (1.0–4.0) (p = 0.0098); 2 patients 2 (3.6%) versus 7 patients (31.8%) had undergone at least one thoracic CT scan (p = 0.001). A self-imposed ultrasound-based approach reduces the number of chest X-rays and thoracic CT scans in COVID-19 patients compared with patients with standard acute respiratory failure, thus reducing the number of health care providers exposed to possible contamination and sparing personal protective equipment.



中文翻译:

急性呼吸衰竭患者的肺超声检查可减少常规影像和医疗保健提供者接触COVID-19的机会。

去年,肺超声作为一种用于评估和管理急性呼吸衰竭患者的影像学技术而处于领先地位。在2019年的冠状病毒病(COVID-19)中,其作用可能更加重要,因为它在床旁进行,可能会限制胸部X线检查以及对计算机断层扫描(CT)扫描运输到放射学的需求。自2月21日起,我们逐渐变成了冠状病毒专用的重症监护室,并采用了基于超声的方法来避免传统成像并尽可能地减少污染。我们进行了每日一次完整的检查,并进行了肺部超声评分计算和系统搜索并发症(气胸,呼吸机相关性肺炎);值班医生可以根据需要自由进行CT或胸部X光检查。我们将COVID-19流行病的前4周与2019年同期进行的常规影像学检查进行了比较:2020年有84例患者,2019年有112例; 64和22(76.2%对19.6%,p <0.001)分别患有急性呼吸衰竭,其中2020年有55(85.9%)是COVID-19。将2020年的COVID-19患者与2019年的急性呼吸衰竭患者进行比较,胸部X光的中位数是1.0(1.0-2.0)对3.0(1.0-4.0)(p  = 0.0098);2位患者2(3.6%)对7位患者(31.8%)进行了至少一次胸部CT扫描(p  = 0.001)。与标准的急性呼吸衰竭患者相比,基于超声的自我施加方法减少了COVID-19患者的胸部X光和胸部CT扫描次数,从而减少了可能受到污染的医疗保健提供者的数量,并节省了个人防护措施设备。

更新日期:2020-06-25
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