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Title: Point-of-care lung ultrasound for the detection of pulmonary manifestations of malaria and sepsis: An observational study
Authors: Stije J. Leopold
Aniruddha Ghose
Katherine A. Plewes
Subash Mazumder
Luigi Pisani
Hugh W.F. Kingston
Sujat Paul
Anupam Barua
M. Abdus Sattar
Michaëla A.M. Huson
Andrew P. Walden
Patricia C. Henwood
Elisabeth D. Riviello
Marcus J. Schultz
Nicholas P.J. Day
Asok Kumar Dutta
Nicholas J. White
Arjen M. Dondorp
Brigham and Women's Hospital
Mahidol University
Chittagong Medical College Hospital
Nuffield Department of Clinical Medicine
Royal Berkshire Hospital
Harvard Medical School
Amsterdam UMC - University of Amsterdam
Keywords: Agricultural and Biological Sciences;Biochemistry, Genetics and Molecular Biology
Issue Date: 1-Dec-2018
Citation: PLoS ONE. Vol.13, No.12 (2018)
Abstract: © 2018 Leopold et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction Patients with severe malaria or sepsis are at risk of developing life-threatening acute respiratory distress syndrome (ARDS). The objective of this study was to evaluate point-of-care lung ultrasound as a novel tool to determine the prevalence and early signs of ARDS in a resource-limited setting among patients with severe malaria or sepsis. Materials and methods Serial point-of-care lung ultrasound studies were performed on four consecutive days in a planned sub study of an observational cohort of patients with malaria or sepsis in Bangladesh. We quantified aeration patterns across 12 lung regions. ARDS was defined according to the Kigali Modification of the Berlin Definition. Results Of 102 patients enrolled, 71 had sepsis and 31 had malaria. Normal lung ultrasound findings were observed in 44 patients on enrolment and associated with 7% case fatality. ARDS was detected in 10 patients on enrolment and associated with 90% case fatality. All patients with ARDS had sepsis, 4 had underlying pneumonia. Two patients developing ARDS during hospitalisation already had reduced aeration patterns on enrolment. The SpO 2 /FiO 2 ratio combined with the number of regions with reduced aeration was a strong prognosticator for mortality in patients with sepsis (AUROC 91.5% (95% Confidence Interval: 84.6%-98.4%)). Conclusions This study demonstrates the potential usefulness of point-of-care lung ultrasound to detect lung abnormalities in patients with malaria or sepsis in a resource-constrained hospital setting. LUS was highly feasible and allowed to accurately identify patients at risk of death in a resource limited setting.
ISSN: 19326203
Appears in Collections:Scopus 2018

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