CORONA (COre ultRasOund of covid in iNtensive care and Acute medicine) study: National service evaluation of lung and heart ultrasound in intensive care patients with suspected or proven COVID-19.

IF 2.1 Q3 CRITICAL CARE MEDICINE

Journal of the Intensive Care Society Pub Date : 2023-05-01 DOI:10.1177/17511437211065611

Prashant Parulekar, James Powys-Lybbe, Thomas Knight, Nicholas Smallwood, Daniel Lasserson, Gavin Rudge, Ashley Miller, Marcus Peck, Jonathon Aron

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引用次数: 1

Abstract

Background: Combined Lung Ultrasound (LUS) and Focused UltraSound for Intensive Care heart (FUSIC Heart - formerly Focused Intensive Care Echocardiography, FICE) can aid diagnosis, risk stratification and management in COVID-19. However, data on its application and results are limited to small studies in varying countries and hospitals. This United Kingdom (UK) national service evaluation study assessed how combined LUS and FUSIC Heart were used in COVID-19 Intensive Care Unit (ICU) patients during the first wave of the pandemic.

Method: Twelve trusts across the UK registered for this prospective study. LUS and FUSIC Heart data were obtained, using a standardised data set including scoring of abnormalities, between 1^st February 2020 to 30th July 2020. The scans were performed by intensivists with FUSIC Lung and Heart competency as a minimum standard. Data was anonymised locally prior to transfer to a central database.

Results: 372 studies were performed on 265 patients. There was a small but significant relationship between LUS score >8 and 30-day mortality (OR 1.8). Progression of score was associated with an increase in 30-day mortality (OR 1.2). 30-day mortality was increased in patients with right ventricular (RV) dysfunction (49.4% vs 29.2%). Severity of LUS score correlated with RV dysfunction (p < 0.05). Change in management occurred in 65% of patients following a combined scan.

Conclusions: In COVID-19 patients, there is an association between lung ultrasound score severity, RV dysfunction and mortality identifiable by combined LUS and FUSIC Heart. The use of 12-point LUS scanning resulted in similar risk score to 6-point imaging in the majority of cases. Our findings suggest that serial combined LUS and FUSIC Heart on COVID-19 ICU patients may aid in clinical decision making and prognostication.

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CORONA(重症监护和急性医学中的covid -19核心超声)研究:怀疑或证实患有covid -19的重症监护患者的肺和心脏超声的国家服务评估。

背景:联合肺超声(LUS)和重症监护心脏聚焦超声(FUSIC heart -原重症监护超声心动图，FICE)可以帮助COVID-19的诊断、风险分层和管理。然而，关于其应用和结果的数据仅限于在不同国家和医院进行的小型研究。这项英国国家服务评估研究评估了在第一波大流行期间，LUS和FUSIC心脏联合应用于COVID-19重症监护病房(ICU)患者的情况。方法:英国12家信托机构注册了这项前瞻性研究。在2020年2月1日至2020年7月30日期间，使用标准化数据集获得LUS和FUSIC心脏数据，包括异常评分。扫描由以FUSIC心肺功能为最低标准的强化医师进行。数据在转移到中央数据库之前在本地进行了匿名处理。结果:共进行372项研究，共265例患者。LUS评分>8与30天死亡率(OR 1.8)之间存在微小但显著的关系。评分的进展与30天死亡率的增加相关(OR 1.2)。右心室功能不全患者的30天死亡率增加(49.4% vs 29.2%)。LUS评分严重程度与右心室功能障碍相关(p < 0.05)。65%的患者在联合扫描后发生了管理上的改变。结论:在COVID-19患者中，肺超声评分严重程度、右心室功能障碍与LUS和FUSIC心脏联合识别的死亡率之间存在关联。在大多数情况下，使用12点LUS扫描导致的风险评分与6点成像相似。我们的研究结果表明，连续联合LUS和FUSIC心脏对COVID-19 ICU患者可能有助于临床决策和预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Intensive Care Society Nursing-Critical Care Nursing

CiteScore

4.40

自引率

0.00%

发文量

期刊介绍： The Journal of the Intensive Care Society (JICS) is an international, peer-reviewed journal that strives to disseminate clinically and scientifically relevant peer-reviewed research, evaluation, experience and opinion to all staff working in the field of intensive care medicine. Our aim is to inform clinicians on the provision of best practice and provide direction for innovative scientific research in what is one of the broadest and most multi-disciplinary healthcare specialties. While original articles and systematic reviews lie at the heart of the Journal, we also value and recognise the need for opinion articles, case reports and correspondence to guide clinically and scientifically important areas in which conclusive evidence is lacking. The style of the Journal is based on its founding mission statement to ‘instruct, inform and entertain by encompassing the best aspects of both tabloid and broadsheet''.