Publication: Lung Ultrasound Assessment of Focal and Non-focal Lung Morphology in Patients With Acute Respiratory Distress Syndrome
Issued Date
2021-09-14
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ISSN
1664042X
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2-s2.0-85116053093
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Mahidol University
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SCOPUS
Bibliographic Citation
Frontiers in Physiology. Vol.12, (2021)
Suggested Citation
Charalampos Pierrakos, Marry R. Smit, Luigi Pisani, Frederique Paulus, Marcus J. Schultz, Jean Michel Constantin, Davide Chiumello, Francesco Mojoli, Silvia Mongodi, Lieuwe D.J. Bos Lung Ultrasound Assessment of Focal and Non-focal Lung Morphology in Patients With Acute Respiratory Distress Syndrome. Frontiers in Physiology. Vol.12, (2021). doi:10.3389/fphys.2021.730857 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/76025
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Title
Lung Ultrasound Assessment of Focal and Non-focal Lung Morphology in Patients With Acute Respiratory Distress Syndrome
Other Contributor(s)
Centre Hospitalier Universitaire Brugmann, Brussels
Università degli Studi di Milano
Fondazione IRCCS Policlinico San Matteo
Università degli Studi di Pavia
Mahidol University
Nuffield Department of Medicine
Sorbonne Universite
Amsterdam UMC - University of Amsterdam
ASST Santi Paolo e Carlo
General Regional Hospital F. Miulli
Università degli Studi di Milano
Fondazione IRCCS Policlinico San Matteo
Università degli Studi di Pavia
Mahidol University
Nuffield Department of Medicine
Sorbonne Universite
Amsterdam UMC - University of Amsterdam
ASST Santi Paolo e Carlo
General Regional Hospital F. Miulli
Abstract
Background: The identification of phenotypes based on lung morphology can be helpful to better target mechanical ventilation of individual patients with acute respiratory distress syndrome (ARDS). We aimed to assess the accuracy of lung ultrasound (LUS) methods for classification of lung morphology in critically ill ARDS patients under mechanical ventilation. Methods: This was a post hoc analysis on two prospective studies that performed LUS and chest computed tomography (CT) scanning at the same time. Expert panels from the two participating centers separately developed two LUS methods for classifying lung morphology based on LUS aeration scores from a 12-region exam (Amsterdam and Lombardy method). Moreover, a previously developed LUS method based on anterior LUS scores was tested (Piedmont method). Sensitivity and specificity of all three LUS methods was assessed in the cohort of the other center(s) by using CT as the gold standard for classification of lung morphology. Results: The Amsterdam and Lombardy cohorts consisted of 32 and 19 ARDS patients, respectively. From these patients, 23 (45%) had focal lung morphology while others had non-focal lung morphology. The Amsterdam method could classify focal lung morphology with a sensitivity of 77% and a specificity of 100%, while the Lombardy method had a sensitivity and specificity of 100 and 61%. The Piedmont method had a sensitivity and specificity of 91 and 75% when tested on both cohorts. With both the Amsterdam and Lombardy method, most patients could be classified based on the anterior regions alone. Conclusion: LUS-based methods can accurately classify lung morphology in invasively ventilated ARDS patients compared to gold standard chest CT. The anterior LUS regions showed to be the most discriminant between focal and non-focal lung morphology, although accuracy increased moderately when lateral and posterior LUS regions were integrated in the method.
