Ultrasound Journal最新文献

{"title":"Detecting cervical esophagus with ultrasound on healthy voluntaries: learning curve.","authors":"Paul-Georges Reuter,&nbsp;Chris Ballouz,&nbsp;Thomas Loeb,&nbsp;Tomislav Petrovic,&nbsp;Frédéric Lapostolle","doi":"10.1186/s13089-023-00315-8","DOIUrl":"https://doi.org/10.1186/s13089-023-00315-8","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to determine the learning curve of tracheal-esophageal ultrasound by prehospital medical and paramedical staff.</p><p><strong>Methods: </strong>A single-center prospective study was carried out at a French EMS (SAMU 92). Volunteer participants first received a short theoretical training through e-learning, followed by two separate hands-on workshops on healthy volunteers, spaced one to two months apart. Learners were timed to obtain the tracheal-esophageal ultrasound target image 10 consecutive times. The first workshop was intended to perform a learning curve, and the second was to assess unlearning. The secondary objectives were to compare performance by profession and by previous ultrasound experience.</p><p><strong>Results: </strong>We included 32 participants with a mean age of 38 (± 10) years, consisting of 56% men. During the first workshop, the target image acquisition time was 20.4 [IQR: 10.6;41] seconds on the first try and 5.02 [3.72;7.5] seconds on the 10th (p < 0.0001). The image acquisition time during the second workshop was shorter compared to the first one (p = 0.016). In subgroup analyses, we found no significant difference between physicians and nurses (p = 0.055 at the first workshop and p = 0.164 at the second) or according to previous ultrasound experience (p = 0.054 at the first workshop and p = 0.176), counter to multivariate analysis (p = 0.02).</p><p><strong>Conclusions: </strong>A short web-based learning completed by a hands-on workshop made it possible to obtain the ultrasound image in less than 10 s, regardless of the profession or previous experience in ultrasound.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10151284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9773387","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":"Unravelling the skillset of point-of-care ultrasound: a systematic review.","authors":"Tessa A Mulder,&nbsp;Tim van de Velde,&nbsp;Eveline Dokter,&nbsp;Bas Boekestijn,&nbsp;Tycho J Olgers,&nbsp;Martijn P Bauer,&nbsp;Beerend P Hierck","doi":"10.1186/s13089-023-00319-4","DOIUrl":"https://doi.org/10.1186/s13089-023-00319-4","url":null,"abstract":"<p><strong>Background: </strong>The increasing number of physicians that are trained in point-of-care ultrasound (POCUS) warrants critical evaluation and improvement of current training methods. Performing POCUS is a complex task and it is unknown which (neuro)cognitive mechanisms are most important in competence development of this skill. This systematic review was conducted to identify determinants of POCUS competence development that can be used to optimize POCUS training.</p><p><strong>Methods: </strong>PubMed, Web of Science, Cochrane Library, Emcare, PsycINFO and ERIC databases were searched for studies measuring ultrasound (US) skills and aptitude. The papers were divided into three categories: \"Relevant knowledge\", \"Psychomotor ability\" and 'Visuospatial ability'. The 'Relevant knowledge' category was further subdivided in 'image interpretation', 'technical aspects' and 'general cognitive abilities'. Visuospatial ability was subdivided in visuospatial subcategories based on the Cattell-Horn-Carroll (CHC) Model of Intelligence v2.2, which includes visuospatial manipulation and visuospatial perception. Post-hoc, a meta-analysis was performed to calculate pooled correlations.</p><p><strong>Results: </strong>26 papers were selected for inclusion in the review. 15 reported on relevant knowledge with a pooled coefficient of determination of 0.26. Four papers reported on psychomotor abilities, one reported a significant relationship with POCUS competence. 13 papers reported on visuospatial abilities, the pooled coefficient of determination was 0.16.</p><p><strong>Conclusion: </strong>There was a lot of heterogeneity in methods to assess possible determinants of POCUS competence and POCUS competence acquisition. This makes it difficult to draw strong conclusions on which determinants should be part of a framework to improve POCUS education. However, we identified two determinants of POCUS competence development: relevant knowledge and visuospatial ability. The content of relevant knowledge could not be retrieved in more depth. For visuospatial ability we used the CHC model as theoretical framework to analyze this skill. We could not point out psychomotor ability as a determinant of POCUS competence.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9752364","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":"Is gallbladder PoCUS diagnostic accuracy accessible to medical students after PoCUS training exclusively on healthy volunteers? A pilot randomized control trial.","authors":"Florence Dupriez,&nbsp;Bastian Rodrigues de Castro,&nbsp;Félix Gendebien,&nbsp;Antoine Fasseaux,&nbsp;Matthieu Gensburger,&nbsp;Laurent Marissiaux,&nbsp;Andrea Penaloza,&nbsp;Xavier Bobbia,&nbsp;Robert Jarman","doi":"10.1186/s13089-023-00317-6","DOIUrl":"https://doi.org/10.1186/s13089-023-00317-6","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (PoCUS) is increasingly used in clinical practice and is now included in many undergraduate curricula. Here, we aimed to determine whether medical students who participated in a PoCUS teaching program with several practical training sessions involving healthy volunteers could achieve a good level of diagnostic accuracy in identifying gallbladder pathologies. The intervention group (IG) was trained exclusively on volunteers with a healthy gallbladder, whereas the control group (CG) had access to volunteers with a pathological gallbladder as recommended in most PoCUS curricula.</p><p><strong>Materials and methods: </strong>Twenty medical students were randomly assigned to the IG and CG. After completing the training program over 2 months, students were evaluated by three independent examiners. Students and examiners were blind to group allocation and study outcome. Sensitivity and specificity of students' PoCUS gallstone diagnosis were assessed. Secondary outcomes were students' confidence, image quality, acquisition time, and PoCUS skills.</p><p><strong>Results: </strong>Sensitivity and specificity for gallstone diagnosis were, respectively, 0.85 and 0.97 in the IG and 0.80 and 0.83 in the CG. Areas under the curve (AUC) based on the receiver operating characteristic curve analysis were 0.91 and 0.82 in the IG and CG, respectively, with no significant difference (p = 0.271) and an AUC difference of -0.092. No significant between-group difference was found for the secondary outcomes.</p><p><strong>Conclusions: </strong>Our pilot study showed that medical students can develop PoCUS diagnostic accuracy after training on healthy volunteers. If these findings are confirmed in a larger sample, this could favor the delivery of large practical teaching sessions without the need to include patients with pathology, thus facilitating PoCUS training for students.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10086079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9289593","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":"Lung ultrasound: are we diagnosing too much?","authors":"Giovanni Volpicelli,&nbsp;Thomas Fraccalini,&nbsp;Luciano Cardinale","doi":"10.1186/s13089-023-00313-w","DOIUrl":"https://doi.org/10.1186/s13089-023-00313-w","url":null,"abstract":"<p><p>The clinical use of lung ultrasound (LUS) has made more efficient many diagnostic processes at bedside. The great power of LUS is a superior diagnostic sensitivity in many applications, when compared to chest radiography (CXR). The implementation of LUS in emergency is contributing to reveal a growing number of radio-occult pulmonary conditions. In some diseases, the superior sensitivity of LUS is a great advantage, like for pneumothorax and pulmonary edema. Diagnosing at bedside pneumothoraxes, pulmonary congestions, and COVID-19 pneumonia that are visible by LUS but undetected by CXR may be decisive for appropriate management, and even for saving lives. However, in other conditions, like bacterial pneumonia and small peripheral infarctions due to subsegmental pulmonary embolism, the high sensitivity of LUS does not always lead to advantages. Indeed, we doubt that it is always necessary to treat by antibiotics patients suspected of lower respiratory tract infection, who show radio-occult pulmonary consolidations, and to treat by anticoagulation patients with small subsegmental pulmonary embolism. The possibility that we are overtreating radio-occult conditions should be investigated with dedicated clinical trials.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10054206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9212841","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":"Geographic variation in point of care ultrasound provision: results from a national audit.","authors":"Sunil Aggarwal,&nbsp;Reshma Shanmugam,&nbsp;Thomas Knight,&nbsp;Catherine Atkin,&nbsp;Sarbjit Clare,&nbsp;Nicholas Smallwood,&nbsp;Daniel Lasserson","doi":"10.1186/s13089-023-00314-9","DOIUrl":"https://doi.org/10.1186/s13089-023-00314-9","url":null,"abstract":"<p><strong>Background: </strong>There is an emerging consensus that point-of-care ultrasound is an essential skill in acute care. This is reflected in recent changes to the Acute Internal Medicine curriculum in the UK. The need to develop and maintain specific ultrasound competencies is now a mandatory component of training. There is a degree of uncertainty as to how existing training infrastructure can best accommodate these changes.</p><p><strong>Methods: </strong>Data were obtained from the latest annual Society for Acute Medicine Benchmarking Audit 2021. All Acute Medical Units in the UK are eligible to participate. Data pertaining to the number of ultrasound machines and number of clinicians that regularly use point of care ultrasound were collected. This was used to develop a series of maps demonstrating variation in provision at the national level.</p><p><strong>Results: </strong>In total, 123 AMUs responded to the questions related to ultrasound prevalence and numbers of trained clinicians. Of these, 78.9% (97/123) reported having access to at least one ultrasound machine. There was at least one clinician that regularly used ultrasound in 81 responding hospitals (65.9%). There was significant geographic heterogeneity in the use of ultrasound and availability of accredited supervisors. At a regional level, ultrasound expertise is typically concentrated within a relatively small number of hospitals.</p><p><strong>Conclusion: </strong>Geographic variation in the use of ultrasound and availability of registered supervisors represents a significant challenge to ultrasound training provision at the national level. Targeted interventions in areas with less developed training infrastructure, such as regional training hubs may be required to ensure more equitable access to training opportunities.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10030694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9508360","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 proposed framework for point of care musculoskeletal ultrasound and ultrasound image-guided interventions by physiotherapists: scope of practice, education and governance.","authors":"Mike Smith,&nbsp;Sue Innes,&nbsp;Stuart Wildman,&nbsp;David Baker","doi":"10.1186/s13089-023-00311-y","DOIUrl":"https://doi.org/10.1186/s13089-023-00311-y","url":null,"abstract":"<p><strong>Background: </strong>The use of point of care ultrasound (PoCUS) in the management of musculoskeletal (MSK) disorders is a diverse area of PoCUS practice. Its use by clinicians, such as physiotherapists, can occur across a wide range of roles and care pathway configurations; however, professional, educational and regulatory uncertainties can leave clinicians, managers and patients at risk.</p><p><strong>Main body: </strong>A PoCUS framework approach (previously applied to support PoCUS consolidation and expansion) is used to frame these proposals. Central to this is the defining of (clinical and sonographic) scope of practice (ScoP). A number of indicative ScoPs are described to both (i) illustrate application of the principles and (ii) provide templates for ScoP derivations for individual services or clinicians. Image-guided MSK interventions are increasingly an aspect of MSK physiotherapy PoCUS. Given the utility of physiotherapists drawing upon their imaging to fully inform the selection (and performance) of such techniques, we present a rationale for competency in undertaking sonographic differentials as a pre-cursor to performing ultrasound image-guided MSK interventions. Alignment of ScoP with the relevant education and formal competency assessments are a cornerstone of the PoCUS framework approach; as such, key aspects of MSK PoCUS education and competency assessment are outlined. Strategies for addressing such requirements in healthcare settings where formal provision is not accessible, are also presented. Governance considerations are aligned with the regulatory environment, including those pertaining to professional guidance and insurance considerations. In addition, generic quality assurance elements are emphasised, as core aspects of high-quality service provision. Whilst the paper clarifies the situation for MSK physiotherapists using PoCUS in the UK, prompts are provided to support other professional groups working in MSK services in the United Kingdom (UK) and MSK physiotherapists/physical therapists in other countries-to facilitate their application of the principles.</p><p><strong>Conclusion: </strong>Acknowledging the breadth of MSK physiotherapy PoCUS practice, this paper draws upon a framework approach to provide integrated ScoP, education/competency and governance solutions, along with mechanisms for other professions working with MSK PoCUS-and physiotherapists/physical therapists outside of the UK-to consolidate and expand their practice.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9513414","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":"Inter-observer and intra-observer variability in ultrasound assessment of gastric content and volume in critically ill patients receiving enteral nutrition.","authors":"Héctor Andrés Ruiz Ávila,&nbsp;Carmelo José Espinosa Almanza,&nbsp;Cindy Yohana Fuentes Barreiro","doi":"10.1186/s13089-023-00312-x","DOIUrl":"https://doi.org/10.1186/s13089-023-00312-x","url":null,"abstract":"<p><strong>Background: </strong>The assessment of gastric content and volume using bedside ultrasound (US) has become a useful tool in emergency departments, anesthesiology departments and inpatient wards, as it provides a rapid and dynamic assessment of the gastric content of patients, which, allows making decisions regarding the risk of regurgitation or the need to adjust the strategy used to induce general anesthesia in patients with a full stomach. This assessment consists of two evaluations: a qualitative one, in which the status of the antrum, in terms of gastric content, is classified into three categories (empty, liquid content and full), and a quantitative one, where gastric volume is estimated. The objective of this study was to estimate the intra-observer and inter-observer agreement in ultrasound assessment of gastric content and volume in critically ill patients receiving enteral nutrition.</p><p><strong>Results: </strong>A total of 41 patients were included and each examiner performed 64 gastric US (n = 128). Participants' average age was 56.5 years (SD ± 12.6) and 63.4% were men. Regarding the qualitative evaluation of the antrum, in supine position both examiners classified the gastric content as grade 0 in 1 gastric US (1.5%), grade 1 in 4 gastric US (6.2%) and grade 2 in 59 (92.1%). Regarding intra-observer variability in the measurement of the area of the antrum, Lin's concordance correlation coefficient (CCC), the difference of means between measurements and the 95% limits of agreement of Bland and Altman values were 0.95 (95% CI 0.940-0.977), - 0.47 cm² (SD ± 1.64) and - 3.70 cm² to 2.75 cm², respectively, in EC1, and 0.94 (95% CI 0.922-0.973), - 0.18 cm² (SD ± 2.18) and - 4.47 cm² to 4.09 cm² in EC2. Concerning to inter-observer variability (EC1 vs EC2) in the measurement of the area of the antrum and of gastric volume, the following CCC, mean difference between measurements and 95% limits of agreement of Bland and Altman values were obtained: measurement of the area of the antrum: 0.84 (95% CI 0.778-0.911), - 0.86 cm² (SD ± 3.38) and - 7.50 cm² to 5.78 cm²; gastric volume measurement: 0.84 (95% CI 0.782-0.913), - 12.3 mL (SD ± 49.2) and - 108.8 mL to 84.0 mL.</p><p><strong>Conclusions: </strong>The assessment of gastric content and volume using bedside US in critically ill patients on mechanical ventilation and receiving enteral nutrition showed a good intra and inter-rater reliability. Most of the patients included in the study had a high risk of pulmonary aspiration, since, according to the results of the gastric US evaluation, they had gastric volumes > 1.5 mL/kg.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10024819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9153800","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":"Start spreading the news: a deliberate approach to POCUS program development and implementation.","authors":"Mathilde Gaudreau-Simard,&nbsp;Elaine Kilabuk,&nbsp;Samantha Halman,&nbsp;Krista Wooller,&nbsp;Michael Y Woo,&nbsp;Robert Arntfield,&nbsp;Irene Ma,&nbsp;Alan J Forster","doi":"10.1186/s13089-023-00309-6","DOIUrl":"https://doi.org/10.1186/s13089-023-00309-6","url":null,"abstract":"<p><p>While there is an expanding body of literature on Point-of-Care Ultrasound (POCUS) pedagogy, administrative elements that are necessary for the widespread adoption of POCUS in the clinical environment have received little attention. In this short communication, we seek to address this gap by sharing our institutional experience with POCUS program development and implementation. The five pillars of our program, selected to tackle local barriers to POCUS uptake, are education, workflow, patient safety, research, and sustainability. Our program logic model outlines the inputs, activities, and outputs of our program. Finally, key indicators for the monitoring of program implementation efforts are presented. Though designed for our local context, this approach may readily be adapted toward other clinical environments. We encourage others leading the integration of POCUS at their centers to adopt this approach not only to achieve sustainable change but also to ensure that quality safeguards are in place.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9998745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9173064","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":"Utility of hand-held ultrasound for image acquisition and interpretation by trained Kenyan providers.","authors":"Grace Wanjiku,&nbsp;Lindsay Dreizler,&nbsp;Shirley Wu,&nbsp;Janette Baird,&nbsp;Benjamin Wachira","doi":"10.1186/s13089-023-00308-7","DOIUrl":"https://doi.org/10.1186/s13089-023-00308-7","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) plays a prominent role in the timely recognition and management of multiple medical, surgical, and obstetric conditions. A POCUS training program for primary healthcare providers in rural Kenya was developed in 2013. A significant challenge to this program is the acquisition of reasonably priced ultrasound machines with adequate image quality and the ability to transmit images for remote review. The goal of this study is to compare the utility of a smartphone-connected, hand-held ultrasound with a traditional ultrasound device for image acquisition and interpretation by trained healthcare providers in Kenya.</p><p><strong>Methods: </strong>This study took place during a routine re-training and testing session for healthcare providers who had already received POCUS training. The testing session involved a locally validated Observed Structured Clinical Exam (OSCE) that assessed trainees' skills in performing the Extended Focused Assessment with Sonography for Trauma (E-FAST) and focused obstetric exams. Each trainee performed the OSCE twice, once using a smartphone-connected hand-held ultrasound and once using their notebook ultrasound model.</p><p><strong>Results: </strong>Five trainees obtained a total of 120 images and were scored on image quality and interpretation. Overall E-FAST imaging quality scores were significantly higher for the notebook ultrasound compared to the hand-held ultrasound but there was no significant difference in image interpretation. Overall focused obstetric image quality and image interpretation scores were the same for both ultrasound systems. When separated into individual E-FAST and focused obstetric views, there were no statistically significant differences in the image quality or image interpretation scores between the two ultrasound systems. Images obtained using the hand-held ultrasound were uploaded to the associated cloud storage using a local 3G-cell phone network. Upload times were 2-3 min.</p><p><strong>Conclusion: </strong>Among POCUS trainees in rural Kenya, the hand-held ultrasound was found to be non-inferior to the traditional notebook ultrasound for focused obstetric image quality, focused obstetric image interpretation, and E-FAST image interpretation. However, hand-held ultrasound use was found to be inferior for E-FAST image quality. These differences were not observed when evaluating each E-FAST and focused obstetric views separately. The hand-held ultrasound allowed for rapid image transmission for remote review.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9139764","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":"Monitoring of pulmonary involvement in critically ill COVID-19 patients - should lung ultrasound be preferred over CT?","authors":"Arthur W E Lieveld,&nbsp;Micah L A Heldeweg,&nbsp;Jasper Schouwenburg,&nbsp;Lars Veldhuis,&nbsp;Mark E Haaksma,&nbsp;Rutger M van Haaften,&nbsp;Berend P Teunissen,&nbsp;Jasper M Smit,&nbsp;Jos Twisk,&nbsp;Leo Heunks,&nbsp;Prabath W B Nanayakkara,&nbsp;Pieter Roel Tuinman","doi":"10.1186/s13089-022-00299-x","DOIUrl":"https://doi.org/10.1186/s13089-022-00299-x","url":null,"abstract":"<p><strong>Background: </strong>It is unclear if relevant changes in pulmonary involvement in critically ill COVID-19 patients can be reliably detected by the CT severity score (CTSS) and lung ultrasound score (LUSS), or if these changes have prognostic implications. In addition, it has been argued that adding pleural abnormalities to the LUSS could improve its prognostic value. The objective of this study was to compare LUSS and CTSS for the monitoring of COVID-19 pulmonary involvement through: first, establishing the correlation of LUSS (± pleural abnormalities) and CTSS throughout admission; second, assessing agreement and measurement error between raters for LUSS, pleural abnormalities, and CTSS; third, evaluating the association of the LUSS (± pleural abnormalities) and CTSS with mortality at different timepoints.</p><p><strong>Methods: </strong>This is a prospective, observational study, conducted during the second COVID-19 wave at the AmsterdamUMC, location VUmc. Adult COVID-19 ICU patients were prospectively included when a CT or a 12-zone LUS was performed at admission or at weekly intervals according to local protocol. Patients were followed 90 days or until death. We calculated the: (1) Correlation of the LUSS (± pleural abnormalities) and CTSS throughout admission with mixed models; (2) Intra-class correlation coefficients (ICCs) and smallest detectable changes (SDCs) between raters; (3) Association between the LUSS (± pleural abnormalities) and CTSS with mixed models.</p><p><strong>Results: </strong>82 consecutive patients were included. Correlation between LUSS and CTSS was 0.45 (95% CI 0.31-0.59). ICCs for LUSS, pleural abnormalities, and CTSS were 0.88 (95% CI 0.73-0.95), 0.94 (95% CI 0.90-0.96), and 0.84 (95% CI 0.65-0.93), with SDCs of 4.8, 1.4, and 3.9. The LUSS was associated with mortality in week 2, with a score difference between patients who survived or died greater than its SDC. Addition of pleural abnormalities was not beneficial. The CTSS was associated with mortality only in week 1, but with a score difference less than its SDC.</p><p><strong>Conclusions: </strong>LUSS correlated with CTSS throughout ICU admission but performed similar or better at agreement between raters and mortality prognostication. Given the benefits of LUS over CT, it should be preferred as initial monitoring tool.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10860999","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}