SHM Converge Scientific Abstract ePoster Gallery-Chest Ultrasound for Respiratory Failure in the Time of Covid

Pdf Summary

This prospective cohort study examined whether bedside ultrasound could improve diagnosis of COVID-19 pneumonia in hospitalized adults with undifferentiated respiratory failure. Conducted at the University of Minnesota between April and August 2020, the study enrolled symptomatic patients who had fever, hypoxia, or worsening oxygen needs and underwent nasal PCR testing for SARS-CoV-2 within 24 hours.<br /><br />Investigators performed a modified lung ultrasound over 10 lung fields, plus focused cardiac views and inferior vena cava (IVC) assessment. Lung findings were translated into a modified lung ultrasound score (LUS) and probability patterns (high, intermediate, low, or alternate probability). IVC measurements were used to estimate right atrial pressure. Ultrasound interpretations were done independently, with at least one reader blinded to PCR results.<br /><br />The study found that a lung ultrasound score of 8 had useful diagnostic performance for COVID-19 pneumonia, with moderate sensitivity and good specificity. Diagnostic accuracy improved when a score of 8 was combined with a normal IVC, increasing specificity and positive predictive value. High-probability lung ultrasound patterns were also reasonably accurate, while adding intermediate patterns improved sensitivity but reduced specificity. Chest x-ray performed worse than ultrasound overall.<br /><br />The authors concluded that lung ultrasound is a valuable point-of-care tool for evaluating hospitalized patients with respiratory failure, and that adding IVC assessment can help distinguish cardiogenic from non-cardiogenic causes, improving specificity for COVID-19 pneumonia. However, they emphasize that COVID-associated lung artifacts are not specific and must be interpreted in clinical context.

Asset Subtitle

Zachary Kaltenborn

Meta Tag

Author List Matthew Yocum, Zachary Kaltenborn

Category Research

Concept Point-of-Care Ultrasound

Concept Thoracic Ultrasound

Concept COVID-19 Pneumonia

Concept Respiratory Failure

Concept Lung Ultrasound Score

Distinguished Non-Finalist

Presenter Organization University of Minnesota

Presenting Author Zachary Kaltenborn

Track Technology in Hospital Medicine

Keywords

COVID-19 pneumonia

lung ultrasound

bedside ultrasound

respiratory failure

SARS-CoV-2 PCR

modified lung ultrasound score

inferior vena cava

point-of-care imaging

diagnostic accuracy

hospitalized adults

Point-of-Care Ultrasound

Thoracic Ultrasound

COVID-19 Pneumonia

Respiratory Failure

Lung Ultrasound Score