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A Lower Global Lung Ultrasound Score Is Associated with Higher Likelihood of Successful Extubation in Invasively Ventilated COVID-19 Patients

Lung ultrasound (LUS) can be used to assess loss of aeration, which is associated with outcome in patients with coronavirus disease 2019 (COVID-19) presenting to the emergency department. We hypothesized that LUS scores are associated with outcome in critically ill COVID-19 patients receiving invasi...

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Autores principales: Pierrakos, Charalampos, Lieveld, Arthur, Pisani, Luigi, Smit, Marry R., Heldeweg, Micah, Hagens, Laura A., Smit, Jasper, Haaksma, Mark, Veldhuis, Lars, Schmidt, Robin Walburgh, Errico, Giacomo, Marinelli, Valentina, Attou, Rachid, David, Cristina E., Zimatore, Claudio, Murgolo, Francesco, Grasso, Salvatore, Mirabella, Lucia, Cinnella, Gilda, De Bels, David, Schultz, Marcus J., Tuinman, Pieter-Roel, Bos, Lieuwe D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The American Society of Tropical Medicine and Hygiene 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8641363/
https://www.ncbi.nlm.nih.gov/pubmed/34662857
http://dx.doi.org/10.4269/ajtmh.21-0545
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author Pierrakos, Charalampos
Lieveld, Arthur
Pisani, Luigi
Smit, Marry R.
Heldeweg, Micah
Hagens, Laura A.
Smit, Jasper
Haaksma, Mark
Veldhuis, Lars
Schmidt, Robin Walburgh
Errico, Giacomo
Marinelli, Valentina
Attou, Rachid
David, Cristina E.
Zimatore, Claudio
Murgolo, Francesco
Grasso, Salvatore
Mirabella, Lucia
Cinnella, Gilda
De Bels, David
Schultz, Marcus J.
Tuinman, Pieter-Roel
Bos, Lieuwe D.
author_facet Pierrakos, Charalampos
Lieveld, Arthur
Pisani, Luigi
Smit, Marry R.
Heldeweg, Micah
Hagens, Laura A.
Smit, Jasper
Haaksma, Mark
Veldhuis, Lars
Schmidt, Robin Walburgh
Errico, Giacomo
Marinelli, Valentina
Attou, Rachid
David, Cristina E.
Zimatore, Claudio
Murgolo, Francesco
Grasso, Salvatore
Mirabella, Lucia
Cinnella, Gilda
De Bels, David
Schultz, Marcus J.
Tuinman, Pieter-Roel
Bos, Lieuwe D.
author_sort Pierrakos, Charalampos
collection PubMed
description Lung ultrasound (LUS) can be used to assess loss of aeration, which is associated with outcome in patients with coronavirus disease 2019 (COVID-19) presenting to the emergency department. We hypothesized that LUS scores are associated with outcome in critically ill COVID-19 patients receiving invasive ventilation. This retrospective international multicenter study evaluated patients with COVID-19–related acute respiratory distress syndrome (ARDS) with at least one LUS study within 5 days after invasive mechanical ventilation initiation. The global LUS score was calculated by summing the 12 regional scores (range 0–36). Pleural line abnormalities and subpleural consolidations were also scored. The outcomes were successful liberation from the ventilator and intensive care mortality within 28 days, analyzed with multistate, competing risk proportional hazard models. One hundred thirty-seven patients with COVID-19–related ARDS were included in our study. The global LUS score was associated with successful liberation from mechanical ventilation (hazard ratio [HR]: 0.91 95% confidence interval [CI] 0.87–0.96; P = 0.0007) independently of the ARDS severity, but not with 28 days mortality (HR: 1.03; 95% CI 0.97–1.08; P = 0.36). Subpleural consolidation and pleural line abnormalities did not add to the prognostic value of the global LUS score. Examinations within 24 hours of intubation showed no prognostic value. To conclude, a lower global LUS score 24 hours after invasive ventilation initiation is associated with increased probability of liberation from the mechanical ventilator COVID–19 ARDS patients, independently of the ARDS severity.
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spelling pubmed-86413632021-12-10 A Lower Global Lung Ultrasound Score Is Associated with Higher Likelihood of Successful Extubation in Invasively Ventilated COVID-19 Patients Pierrakos, Charalampos Lieveld, Arthur Pisani, Luigi Smit, Marry R. Heldeweg, Micah Hagens, Laura A. Smit, Jasper Haaksma, Mark Veldhuis, Lars Schmidt, Robin Walburgh Errico, Giacomo Marinelli, Valentina Attou, Rachid David, Cristina E. Zimatore, Claudio Murgolo, Francesco Grasso, Salvatore Mirabella, Lucia Cinnella, Gilda De Bels, David Schultz, Marcus J. Tuinman, Pieter-Roel Bos, Lieuwe D. Am J Trop Med Hyg Articles Lung ultrasound (LUS) can be used to assess loss of aeration, which is associated with outcome in patients with coronavirus disease 2019 (COVID-19) presenting to the emergency department. We hypothesized that LUS scores are associated with outcome in critically ill COVID-19 patients receiving invasive ventilation. This retrospective international multicenter study evaluated patients with COVID-19–related acute respiratory distress syndrome (ARDS) with at least one LUS study within 5 days after invasive mechanical ventilation initiation. The global LUS score was calculated by summing the 12 regional scores (range 0–36). Pleural line abnormalities and subpleural consolidations were also scored. The outcomes were successful liberation from the ventilator and intensive care mortality within 28 days, analyzed with multistate, competing risk proportional hazard models. One hundred thirty-seven patients with COVID-19–related ARDS were included in our study. The global LUS score was associated with successful liberation from mechanical ventilation (hazard ratio [HR]: 0.91 95% confidence interval [CI] 0.87–0.96; P = 0.0007) independently of the ARDS severity, but not with 28 days mortality (HR: 1.03; 95% CI 0.97–1.08; P = 0.36). Subpleural consolidation and pleural line abnormalities did not add to the prognostic value of the global LUS score. Examinations within 24 hours of intubation showed no prognostic value. To conclude, a lower global LUS score 24 hours after invasive ventilation initiation is associated with increased probability of liberation from the mechanical ventilator COVID–19 ARDS patients, independently of the ARDS severity. The American Society of Tropical Medicine and Hygiene 2021-12 2021-10-18 /pmc/articles/PMC8641363/ /pubmed/34662857 http://dx.doi.org/10.4269/ajtmh.21-0545 Text en © The American Society of Tropical Medicine and Hygiene https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Articles
Pierrakos, Charalampos
Lieveld, Arthur
Pisani, Luigi
Smit, Marry R.
Heldeweg, Micah
Hagens, Laura A.
Smit, Jasper
Haaksma, Mark
Veldhuis, Lars
Schmidt, Robin Walburgh
Errico, Giacomo
Marinelli, Valentina
Attou, Rachid
David, Cristina E.
Zimatore, Claudio
Murgolo, Francesco
Grasso, Salvatore
Mirabella, Lucia
Cinnella, Gilda
De Bels, David
Schultz, Marcus J.
Tuinman, Pieter-Roel
Bos, Lieuwe D.
A Lower Global Lung Ultrasound Score Is Associated with Higher Likelihood of Successful Extubation in Invasively Ventilated COVID-19 Patients
title A Lower Global Lung Ultrasound Score Is Associated with Higher Likelihood of Successful Extubation in Invasively Ventilated COVID-19 Patients
title_full A Lower Global Lung Ultrasound Score Is Associated with Higher Likelihood of Successful Extubation in Invasively Ventilated COVID-19 Patients
title_fullStr A Lower Global Lung Ultrasound Score Is Associated with Higher Likelihood of Successful Extubation in Invasively Ventilated COVID-19 Patients
title_full_unstemmed A Lower Global Lung Ultrasound Score Is Associated with Higher Likelihood of Successful Extubation in Invasively Ventilated COVID-19 Patients
title_short A Lower Global Lung Ultrasound Score Is Associated with Higher Likelihood of Successful Extubation in Invasively Ventilated COVID-19 Patients
title_sort lower global lung ultrasound score is associated with higher likelihood of successful extubation in invasively ventilated covid-19 patients
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8641363/
https://www.ncbi.nlm.nih.gov/pubmed/34662857
http://dx.doi.org/10.4269/ajtmh.21-0545
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