Publication: A lower global lung ultrasound score is associated with higher likelihood of successful extubation in invasively ventilated COVID-19 patients
Issued Date
2021-12-01
Resource Type
ISSN
14761645
00029637
00029637
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2-s2.0-85121377158
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.105, No.6 (2021), 1490-1497
Suggested Citation
Charalampos Pierrakos, Arthur Lieveld, Luigi Pisani, Marry R. Smit, Micah Heldeweg, Laura A. Hagens, Jasper Smit, Mark Haaksma, Lars Veldhuis, Robin Walburgh Schmidt, Giacomo Errico, Valentina Marinelli, Rachid Attou, Cristina E. David, Claudio Zimatore, Francesco Murgolo, Salvatore Grasso, Lucia Mirabella, Gilda Cinnella, David de Bels, Marcus J. Schultz, Pieter Roel Tuinman, Lieuwe D. Bos A lower global lung ultrasound score is associated with higher likelihood of successful extubation in invasively ventilated COVID-19 patients. American Journal of Tropical Medicine and Hygiene. Vol.105, No.6 (2021), 1490-1497. doi:10.4269/ajtmh.21-0545 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/77131
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Title
A lower global lung ultrasound score is associated with higher likelihood of successful extubation in invasively ventilated COVID-19 patients
Author(s)
Charalampos Pierrakos
Arthur Lieveld
Luigi Pisani
Marry R. Smit
Micah Heldeweg
Laura A. Hagens
Jasper Smit
Mark Haaksma
Lars Veldhuis
Robin Walburgh Schmidt
Giacomo Errico
Valentina Marinelli
Rachid Attou
Cristina E. David
Claudio Zimatore
Francesco Murgolo
Salvatore Grasso
Lucia Mirabella
Gilda Cinnella
David de Bels
Marcus J. Schultz
Pieter Roel Tuinman
Lieuwe D. Bos
Arthur Lieveld
Luigi Pisani
Marry R. Smit
Micah Heldeweg
Laura A. Hagens
Jasper Smit
Mark Haaksma
Lars Veldhuis
Robin Walburgh Schmidt
Giacomo Errico
Valentina Marinelli
Rachid Attou
Cristina E. David
Claudio Zimatore
Francesco Murgolo
Salvatore Grasso
Lucia Mirabella
Gilda Cinnella
David de Bels
Marcus J. Schultz
Pieter Roel Tuinman
Lieuwe D. Bos
Abstract
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 5 0.0007) independently of the ARDS severity, but not with 28 days mortality (HR: 1.03; 95% CI 0.97-1.08; P 5 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.