Publication: Lung ultrasound for detection of pulmonary complications in critically ill obstetric patients in a resource-limited setting
Issued Date
2021-02-01
Resource Type
ISSN
14761645
00029637
00029637
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2-s2.0-85101468220
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.104, No.2 (2021), 478-486
Suggested Citation
Luigi Pisani, Anna de Nicolo, Marcella Schiavone, Adetunji O. Adeniji, Angela de Palma, Francesco Di Gennaro, Edward Ejiro Emuveyan, Salvatore Grasso, Patricia C. Henwood, Alimamy P. Koroma, Stije Leopold, Claudia Marotta, Giuseppe Marulli, Giovanni Putoto, Enzo Pisani, James Russel, Ary Serpa Neto, Arjen M. Dondorp, Eva Hanciles, Michael M. Koroma, Marcus J. Schultz Lung ultrasound for detection of pulmonary complications in critically ill obstetric patients in a resource-limited setting. American Journal of Tropical Medicine and Hygiene. Vol.104, No.2 (2021), 478-486. doi:10.4269/ajtmh.20-0996 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77328
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Title
Lung ultrasound for detection of pulmonary complications in critically ill obstetric patients in a resource-limited setting
Author(s)
Luigi Pisani
Anna de Nicolo
Marcella Schiavone
Adetunji O. Adeniji
Angela de Palma
Francesco Di Gennaro
Edward Ejiro Emuveyan
Salvatore Grasso
Patricia C. Henwood
Alimamy P. Koroma
Stije Leopold
Claudia Marotta
Giuseppe Marulli
Giovanni Putoto
Enzo Pisani
James Russel
Ary Serpa Neto
Arjen M. Dondorp
Eva Hanciles
Michael M. Koroma
Marcus J. Schultz
Anna de Nicolo
Marcella Schiavone
Adetunji O. Adeniji
Angela de Palma
Francesco Di Gennaro
Edward Ejiro Emuveyan
Salvatore Grasso
Patricia C. Henwood
Alimamy P. Koroma
Stije Leopold
Claudia Marotta
Giuseppe Marulli
Giovanni Putoto
Enzo Pisani
James Russel
Ary Serpa Neto
Arjen M. Dondorp
Eva Hanciles
Michael M. Koroma
Marcus J. Schultz
Abstract
Critically ill parturients have an increased risk of developing pulmonary complications. Lung ultrasound (LUS) could be effective in addressing the cause of respiratory distress in resource-limited settings with high maternal mortality. We aimed to determine the frequency, timing of appearance, and type of pulmonary complications in critically ill parturients in an obstetric unit in Sierra Leone. In this prospective observational study, LUS examinations were performed on admission, after 24 and 48 hours, and in case of respiratory deterioration. Primary endpoint was the proportion of parturients with one or more pulmonary complications, stratified for the presence of respiratory distress. Secondary endpoints included timing and types of complications, and their association with “poor outcome,” defined as a composite of transfer for escalation of care or death. Of 166 patients enrolled, 35 patients (21% [95% CI: 15-28]) had one or more pulmonary complications, the majority diagnosed on admission. Acute respiratory distress syndrome (period prevalence 4%) and hydrostatic pulmonary edema (4%) were only observed in patients with respiratory distress. Pneumonia (2%), atelectasis (10%), and pleural effusion (7%) were present, irrespective of respiratory distress. When ultrasound excluded pulmonary complications, respiratory distress was related to anemia or metabolic acidosis. Pulmonary complications were associated with an increased risk of poor outcome (odds ratio: 5.0; 95% CI: 1.7-14.6; P = 0.003). In critically ill parturients in a resource-limited obstetric unit, LUS contributed to address the cause of respiratory distress by identifying or excluding pulmonary complications. These were associated with a poor outcome.