Ultrasound Journal最新文献

{"title":"The predictive value of different lung ultrasound protocols for extravascular lung water in septic shock patients.","authors":"Yuan Ding, Feng Qian, Yang Feng, Bin Zhu, Yibo Ma","doi":"10.5826/tuj.2026.18843","DOIUrl":"10.5826/tuj.2026.18843","url":null,"abstract":"<p><strong>Background: </strong>Currently, the role of lung ultrasound (LUS) in the diagnosis and treatment of patients with septic shock is widely recognized. Various LUS protocols and scoring criteria have been proposed, yet a unified LUS protocol for assessing lung water in these patients remains lacking.</p><p><strong>Methods: </strong>Forty‑six septic shock patients underwent LUS with three scanning schemes (4‑region, 8‑region, BLUE) alongside pulse indicated continuous cardiac output (PiCCO) monitoring. Spearman correlation analysis was used to compare the correlation between the three ultrasound scoring schemes, PiCCO and other clinical laboratory indicators. At the same time, the value of three LUS protocols for assessing pulmonary water in septic shock patients was evaluated using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Spearman's correlation analysis showed a significant correlation between extravascular lung water index (EVLWI) and 4-region, 8-region, or the Bedside Lung Ultrasound Examination (BLUE) protocol. More importantly, the BLUE protocol showed a stronger correlation with EVLWI than the 4-region protocol and the 8-region protocol (r=0.634, 0.458, 0.546, p<0.001). The ROC curve analysis showed that ultrasound protocols could predict the early occurrence of pulmonary edema in septic shock patients (EVLWI>7 ml/kg), diagnosis of pulmonary edema (EVLWI>10 ml/kg), and evaluation of pulmonary fluid severity (EVLWI≥15 ml/kg).</p><p><strong>Conclusions: </strong>Our study found that septic shock patients were prone to pulmonary edema during fluid resuscitation, and ultrasound scoring could help us quantify pulmonary edema. Among the 4-region, 8-region and BLUE protocols, the BLUE protocol shows relatively better overall performance in predicting lung water elevation and evaluating edema severity.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18843"},"PeriodicalIF":3.6,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and early experience with venous Doppler congestion assessment in post-operative lung transplant patients.","authors":"Govind Pandompatam, Tathagat Narula, Francisco Alvarez, Prasanth Balasubramanian, Ricardo Diaz Milian, Nathan Waldron, Hari Kalagara","doi":"10.5826/tuj.2026.18681","DOIUrl":"10.5826/tuj.2026.18681","url":null,"abstract":"<p><strong>Background: </strong>The role of venous Doppler ultrasound in assessing venous congestion in the setting of post-lung transplantation surgery is unknown. We performed a feasibility study on the use of venous Doppler ultrasound in the immediate post-operative period after lung transplantation in a retrospective, single-center observational evaluation. Patients had at least two venous congestion Doppler ultrasound exams involving interrogation of IVC diameter, hepatic vein, portal vein and renal vein Doppler assessments.  Results: A total of 9 patients were included in our study with a median age of 60 years, 66.7% being male, and a median BMI of 20.9. All patients had VExUS grade ≥1 on their first venous Doppler exam. All nine patients had a decrease in portal vein pulsatility from initial to final exams. Correlation between portal venous pulsatility and net fluid balance was not statistically significant R= 0.33 (P= 0.39). Other parameters, including VExUS grade, IVC diameter, HV and RV Doppler changes from initial to final ultrasound exams showed variable changes in the post-operative period.</p><p><strong>Conclusion: </strong>Venous congestion Doppler ultrasound assessments appear feasible in immediate postoperative lung transplant patients. A multitude of factors beyond fluid status likely affect waveforms.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18681"},"PeriodicalIF":3.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified lung ultrasound score and related findings in children with Mycoplasma pneumoniae pneumonia.","authors":"Wen Xie, Weiru Lin, Qiaohong Zhuang, Guorong Lyu","doi":"10.5826/tuj.2026.18875","DOIUrl":"10.5826/tuj.2026.18875","url":null,"abstract":"<p><strong>Background: </strong>Different pathogens cause pneumonia with overlapping symptoms, labs, and imaging, complicating early diagnosis. The modified lung ultrasound score (MLUS) shows value in lung disease evaluation, but its ability to differentiate pathogens is unclear. This study assessed MLUS for early identification of mycoplasma, viral, and bacterial pneumonia in children.</p><p><strong>Methods: </strong>We enrolled 186 children with suspected pneumonia (Jan-Dec 2023). Clinical data, labs, lung ultrasound findings (A-lines, B-lines, solid lesions, pleural effusion), and pathogens were recorded. MLUS was assigned. Based on pathogens, cases were grouped into mycoplasma (n=74), viral (n=63), and bacterial (n=49) pneumonia for comparison.</p><p><strong>Results: </strong>1. The median age of the mycoplasma pneumonia group was 6 (4.58,8) years, greater than that of the bacterial pneumonia group (3 [1.1,4.83] years) and the viral pneumonia group (3.41 [1.16,4.75] years) (P＜ 0.05). The mycoplasma pneumonia group had more febrile symptoms, extensive solid lung lesions, and fewer asthmatic symptoms than the other two pathogen groups (P < 0.05). 2. The median MLUS for mycoplasma pneumonia group was 15 (10,22), significantly higher than the median score of 9 (5,16) in the bacterial pneumonia group and 8 (5,15) in the viral pneumonia group (P < 0.05). 3. Coughing up sputum and small lung solid changes were significantly more common in the mycoplasma pneumonia group than in the bacterial pneumonia group (P < 0.05).</p><p><strong>Conclusions: </strong>A high modified lung ultrasound score, extensive solid lung lesions, older age, fever, and fewer shortness-of-breath symptoms strongly suggest mycoplasma pneumoniae infection. These findings provide critical evidence for early, targeted clinical management.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18875"},"PeriodicalIF":3.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care ultrasound training using near-peer training and remote Supervision: A pilot randomized controlled trial.","authors":"Nin-Chieh Hsu, Chih-Wei Yang, Yu-Feng Lin, Hung-Bin Tsai, Charles Liao, Chao-Chi Ho, Chong-Jen Yu","doi":"10.5826/tuj.2026.18577","DOIUrl":"10.5826/tuj.2026.18577","url":null,"abstract":"<p><strong>Background and objective: </strong>Traditional point-of-care ultrasound (PoCUS) teaching that relies on hands-on practice faces challenges of limited scale and infection-control constraints during pandemics. We designed a low-contact curriculum integrating near-peer teaching (NPT) with faculty remote supervision (RS) and evaluated its effectiveness versus on-site faculty-led teaching.</p><p><strong>Methods: </strong>In this randomized controlled pilot trial, 69 senior medical students were assigned to NPT+RS (n=34) or faculty-led control group (n=35). Both groups received identical didactic and hands-on training, with the NPT+RS group incorporating multi-camara telemedicine supervision by the faculty to support NPT. The primary outcome was the Entrustable Professional Activity (EPA)-based Objective Structured Clinical Examination (OSCE) score with four major domains measured 1 month after training. The secondary outcomes included the technology acceptance model (TAM) survey and the OSCE feedback.</p><p><strong>Results: </strong>Total OSCE scores (74.9 vs 76.8; p=0.614) and the Indication-Acquisition-Interpretation-Medical decision domain scores did not differ between two groups. For single items, only a lower interpretation performance at the posterolateral alveolar/pleural syndrome in NPT+RS group (4.6 vs 6.5; p=0.013) was found. The NPT+RS group reported higher perceived usefulness (efficiency, usefulness, performance, productivity; all p<0.05), with no between-group difference in perceived ease-of-use. The OSCE was more often perceived by the NPT+RS group as revealing weaknesses (p=0.002) and meriting routine post-training implementation (p=0.034).</p><p><strong>Conclusions: </strong>A low-contact PoCUS curriculum integrating NPT with RS achieved overall EPA-based OSCE performance comparable to traditional faculty-led instruction while enhancing perceived usefulness and assessment acceptance. Implementation of this model allows for greater training capacity and decreased contact. The capacity of NPT for image-interpretation skills warrants investigation.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18577"},"PeriodicalIF":3.6,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of artificial intelligence in fracture detection with ultrasound: A systematic review and meta-analysis.","authors":"Michael Xie, Justin Jy Kim, James Hb Im, Liz Dennett, Abhilash Hareendranathan, Jacob L Jaremko","doi":"10.5826/tuj.2026.18778","DOIUrl":"10.5826/tuj.2026.18778","url":null,"abstract":"<p><strong>Background: </strong>Bone fractures are common in acute care, and point-of-care ultrasound (POCUS) is an emerging diagnostic tool that can be complementary to or even in some cases an alternative to X-ray imaging. With the rise of artificial intelligence (AI) model incorporation in diagnostic interpretations, this systematic review and meta-analysis aimed to evaluate the diagnostic performance of deep learning models for detecting bone fractures on ultrasound images, using radiographic imaging with expert interpretation as the reference standard.</p><p><strong>Methods: </strong>Comprehensive literature searches were conducted from inception to 15 August 2025, in databases including MEDLINE (Ovid interface), Embase (Ovid interface), CINAHL Plus with Full Text (EBSCOhost interface), Web of Science, ACM Digital Library, Scopus, and Google Scholar. We included studies evaluating deep learning models applied to ultrasound images or sweeps for fracture classification. The included studies predominantly evaluated pediatric cohorts presenting to emergency departments with suspected upper extremity fractures. Sensitivity and specificity were pooled using a bivariate random-effects model on the logit scale, and summary receiver operating characteristic (sROC) curve was constructed. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool.</p><p><strong>Results: </strong>A total of 580 papers were identified in the preliminary literature search, and 333 studies were screened after duplicate removal. Screening 27 full-text articles resulted in eight studies that were included in the review. Across 21 reported model evaluations from five studies with extractable diagnostic data, pooled sensitivity was 0.77 (95% CI: 0.69-0.83) and pooled specificity was 0.90 (95% CI: 0.86-0.94), with an overall sROC AUC of 0.91. Patient-level evaluations yielded higher pooled sensitivity (0.89; 95% CI: 0.81-0.94) and specificity (0.94; 95% CI: 0.81-0.98) compared to video-level analyses.</p><p><strong>Conclusions: </strong>AI-assisted ultrasound demonstrates promising diagnostic performance for fracture detection with generally high specificity and variable sensitivity across architectures and anatomic targets. Future work should prioritize prospective, externally validated studies with standardized acquisition protocols and clinically meaningful reporting at the patient level.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18778"},"PeriodicalIF":3.6,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A hybrid radiomics framework integrating genetic algorithm-optimized random forest for preoperative identification of Luminal B breast cancer and Ki-67 prediction: A multicenter study.","authors":"Zimei Lin, Yi-Jie Chen, Yong-Yuan Xu, Qing Wen, Ling-Ling Chen, Li-Ming Shao, Xiao-Yan Niu, Li-Na Tang, Pintong Huang","doi":"10.5826/tuj.2026.18667","DOIUrl":"10.5826/tuj.2026.18667","url":null,"abstract":"<p><strong>Background: </strong>Preoperative identification of Luminal B breast cancer remains a clinical challenge. This study aimed to develop an ultrasound radiomics framework integrating tumoral and peritumoral information for preoperative identification of Luminal B subtype and prediction of Ki-67 status.</p><p><strong>Methods: </strong>We retrospectively analyzed 1,944 patients from three centers. The development cohort from Centers One and Two was divided by stratified sampling into a training set (n = 1,434) and an internal test set (n = 253), and an independent cohort from Center Three (n = 257) was used for external validation. Lesion-containing ROIs were processed using deep learning-assisted segmentation and standardized for downstream analysis. Radiomic features were extracted, and a genetic algorithm (GA) was coupled with a random forest (RF) classifier to construct two models: one for Luminal B classification and another for predicting Ki-67 expression.</p><p><strong>Results: </strong>The combined tumor-peritumoral model achieved the highest performance, with the Luminal B classifier showing AUCs of 0.876 (training), 0.693 (test), and 0.786 (external validation). The Ki-67 prediction model yielded AUCs of 0.890 (training) and 0.858 (test), though external validation (AUC=0.661) was limited by dataset distribution. The Delong test confirmed that combined ROIs significantly outperformed tumor-only models, with NRI and IDI tests further validating the added value of peritumoral features.</p><p><strong>Conclusions: </strong>Ultrasound radiomics integrating tumoral and peritumoral regions can support the preoperative identification of Luminal B breast cancer, and peritumoral region analysis significantly enhances predictive performance. The framework also shows potential for predicting Ki-67 status within this subtype.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18667"},"PeriodicalIF":3.6,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress in lung ultrasound education: An updated systematic review.","authors":"Pernilla G Borggaard, Christian Kildegaard, Christian B Laursen, Rahul Bhatnagar, Giovanni Volpicelli, Pia Iben Pietersen","doi":"10.5826/tuj.2026.18361","DOIUrl":"10.5826/tuj.2026.18361","url":null,"abstract":"<p><strong>Background: </strong>Thoracic ultrasound (TUS) is integrated into clinical practice across various medical specialties to aid with diagnosis and procedural safety. Significant variability in training approaches and standards exists between nations and individual centres.</p><p><strong>Aim and objectives: </strong>To review how differences in published TUS training methods impact upon learning.</p><p><strong>Methods: </strong>A literature search following PRISMA guidelines was conducted in Medline, Embase, Cochrane Library and Scopus, from Jan 2017 until May 2025. Studies involving TUS education using pre- and post-assessments of learning were included.</p><p><strong>Results: </strong>12,460 studies were screened, 235 full texts assessed, and 68 were included in the review. Studies were mainly observational cohorts targeting different healthcare professionals. Ten randomized controlled trials, four non-randomized comparison and one switching replications evaluating different interventions were identified. Physicians were the primary audience in 65% while 29% focused on other healthcare professionals. Class-based teaching was the most common educational tool (66%) sometimes combined with web-based (16%). 84% of studies involved practical training, with training on humans alone (in 63% of cases). Most educational tools led to significant improvements in test scores, although assessment validity was rarely addressed.</p><p><strong>Conclusion: </strong>Our review confirms various TUS educational methods are used in heterogenous participants. While most interventions demonstrated positive learning effects, few studies addressed how this translates to safe clinical use.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18361"},"PeriodicalIF":3.6,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of ultrasound in assessing medial collateral ligament and medial meniscus injuries? A systematic review and meta-analysis.","authors":"Melanie Potter, Anthony Smith","doi":"10.5826/tuj.2026.18171","DOIUrl":"10.5826/tuj.2026.18171","url":null,"abstract":"<p><strong>Background: </strong>Medial Collateral Ligament (MCL) and Medial Meniscus (MM) injuries are common medial knee pathologies. While MRI and arthroscopy are gold-standard diagnostic modalities, they are costly, invasive, and often delayed. Ultrasound is fast, inexpensive, and non-invasive, with growing use clinically, particularly point-of-care ultrasound (POCUS). This systematic review and meta-analysis aims were to evaluate ultrasound's diagnostic performance for MCL and MM injuries, both as standalone modalities and initial screening tools.</p><p><strong>Methods: </strong>A systematic search of PubMed, Cochrane, Embase, CINAHL, and Google Scholar identified studies between 1st October 2014 and 31st October 2024. Fourteen studies (1,259 patients) met inclusion criteria. Methodological quality was assessed using validated tools.</p><p><strong>Results: </strong>Overall risk of bias was low, with moderate certainty of evidence for MCL and low certainty for MM injuries. Nine studies (713 patients) evaluated MCL injuries. Bivariate meta-analysis showed pooled sensitivity 0.83 (95% CI: 0.76-0.88), specificity 0.96 (95% CI: 0.91-0.98), diagnostic odds ratio (DOR) 117.8, and area under the SROC curve (AUC) 0.90. Heterogeneity was minimal (I² = 0%). Twelve studies (969 patients) evaluated MM injuries, with pooled sensitivity 0.85 (95% CI: 0.82-0.88), specificity 0.89 (95% CI: 0.81-0.94), DOR 45, and AUC 0.88. Heterogeneity was low for sensitivity but substantial for specificity (I² = 70.6%).</p><p><strong>Conclusions: </strong>Ultrasound demonstrated high specificity for MCL and moderate sensitivity for MM injuries. It may serve as a valuable modality for MCL injuries in POCUS settings and as an initial screening tool for MM injuries. As POCUS utilisation expands, it may support diagnostic pathways.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18171"},"PeriodicalIF":3.6,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Splanchnic ultrasound to guide unloading in VA-ECMO.","authors":"Guido Tavazzi, Stefano Avondo, Francesco Corradi","doi":"10.5826/tuj.2026.18796","DOIUrl":"10.5826/tuj.2026.18796","url":null,"abstract":"<p><p>Patients supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may require left ventricular (LV) unloading to prevent pulmonary congestion and adverse hemodynamic interactions. However, defining the need and timing of unloading remains challenging, as current approaches rely predominantly on cardiac and pulmonary parameters, often neglecting systemic and organ-level congestion. We report the case of a 53-year-old woman admitted with cardiogenic shock following pericardial drainage and mediastinal mass biopsy. Due to rapid hemodynamic deterioration, VA-ECMO was initiated, resulting in stabilization. Early echocardiographic assessment showed severe biventricular dysfunction but evidence of partial aortic valve opening without LV distension. To further characterize the hemodynamic profile, splanchnic Doppler ultrasound was performed, demonstrating preserved renal arterial flow (resistive index <0.72), continuous intrarenal venous flow, and low portal vein pulsatility (<30%), consistent with a non-congestive phenotype. Based on this integrated assessment, LV unloading was deferred. Subsequent pulmonary artery catheterization confirmed low filling pressures despite reduced cardiac output. A diagnosis of stress-induced cardiomyopathy was suspected, and levosimendan was administered, leading to rapid improvement in cardiac function and successful ECMO weaning. Final pathology revealed a thymic neuroendocrine carcinoma. This case highlights the limitations of relying solely on cardiac indices to guide LV unloading decisions during VA-ECMO. Splanchnic Doppler provided a non-invasive, real-time evaluation of the perfusion-congestion balance at the organ level, complementing echocardiographic and invasive hemodynamic data. The integration of multimodal monitoring may allow a more comprehensive understanding of patient-device interaction and support individualized management strategies. Further research is needed to validate the role of splanchnic ultrasound in guiding unloading decisions and optimizing outcomes in patients with cardiogenic shock supported by VA-ECMO.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18796"},"PeriodicalIF":3.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of post-extubation stridor using ultrasound measurement of subglottic airway diameter.","authors":"Nichanan Jongthitinon, Kantara Saelim, Supika Kritsanepaiboon, Kanokpan Ruangnapa, Pharsai Prasertsan, Wanaporn Anuntaseree","doi":"10.5826/tuj.2026.18517","DOIUrl":"10.5826/tuj.2026.18517","url":null,"abstract":"<p><strong>Background: </strong>Post-extubation stridor (PES) is a common complication in children in the pediatric intensive care unit (PICU). Despite the evaluation of various predictive tests, no single method has consistently demonstrated strong predictive value for PES. We evaluated the diagnostic utility of subglottic diameter ultrasonography for predicting PES within 48-h post-extubation in children.</p><p><strong>Material and methods: </strong>The prospective observational study in university-affiliated PICU was done in children aged 1 month to 15 years who successfully passed a spontaneous breathing trial (SBT) and were scheduled for extubation were enrolled between January 2024 and January 2025. During SBT and cuff deflation, subglottic ultrasonography was performed at a peak inspiratory pressure (PIP) of 15 cmH2O, and the subglottic ratio (SR) and intracricoid peritubular free space (IPFS) were calculated. Leak percentage was calculated as the ratio of the difference between inspiratory and expiratory volumes over inspiratory volume at each PIP level.</p><p><strong>Results: </strong>PES occurred in 33 of 176 (18.75%) patients. In children aged ≥1 year, SR was significantly associated with PES (adjusted OR, 3.78; 95% CI: 1.28-12.21). An SR <1.30 showed 70% sensitivity, 65% specificity, and 66% accuracy. IPFS <2.08 mm demonstrated 80% sensitivity, 65% specificity, and 68% accuracy. A leak percentage <36.77% at 25 cmH2O yielded 80% sensitivity, 47% specificity, and 53% accuracy. AUC values for SR, IPFS, and leak percentage were 0.664, 0.691, and 0.648, respectively.</p><p><strong>Conclusion: </strong>Among the evaluated parameters, IPFS showed the highest diagnostic performance for predicting PES, slightly outperforming the subglottic ratio in patients aged ≥1 year.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18517"},"PeriodicalIF":3.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}