TY - JOUR
T1 - Modified Lung Ultrasound Score for Assessing and Monitoring Pulmonary Aeration
AU - Mongodi, Silvia
AU - Bouhemad, Bélaïd
AU - Orlando, Anita
AU - Stella, Andrea
AU - Tavazzi, Guido
AU - Via, Gabriele
AU - Iotti, Giorgio Antonio
AU - Braschi, Antonio
AU - Mojoli, Francesco
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Purpose Lung Ultrasound Score (LUSS) is a useful tool for lung aeration assessment but presents two theoretical limitations. First, standard LUSS is based on longitudinal scan and detection of number/coalescence of B lines. In the longitudinal scan pleura visualization is limited by intercostal space width. Moreover, coalescence of B lines to define severe loss of aeration is not suitable for non-homogeneous lung pathologies where focal coalescence is possible. We therefore compared longitudinal vs. transversal scan and also cLUSS (standard coalescence-based LUSS) vs. qLUSS (quantitative LUSS based on % of involved pleura). Materials and methods 38 ICU patients were examined in 12 thoracic areas in longitudinal and transversal scan. B lines (number, coalescence), subpleural consolidations (SP), pleural length and pleural involvement (> or ≤50%) were assessed. cLUSS and qLUSS were computed in longitudinal and transversal scan. Results Transversal scan visualized wider (3.9 [IQR 3.8-3.9] vs 2.0 [1.6-2.5] cm, p<0.0001) and more constant (variance 0.02 vs 0.34cm, p<0.0001) pleural length, more B lines (70 vs 59% of scans, p<0.0001), coalescence (39 vs 28%, p<0.0001) and SP (22 vs 14%, p<0.0001) compared to longitudinal scan. Pleural involvement >50% was observed in 17% and coalescence in 33% of cases. Focal coalescence accounted for 52% of cases of coalescence. qLUSS-transv generated a different distribution of aeration scores compared to cLUSS-long (p<0.0001). Conclusion In unselected ICU patients, variability of pleural length in longitudinal scans is high and focal coalescence is frequent. Transversal scan and quantification of pleural involvement are simple measures to overcome these limitations of LUSS.
AB - Purpose Lung Ultrasound Score (LUSS) is a useful tool for lung aeration assessment but presents two theoretical limitations. First, standard LUSS is based on longitudinal scan and detection of number/coalescence of B lines. In the longitudinal scan pleura visualization is limited by intercostal space width. Moreover, coalescence of B lines to define severe loss of aeration is not suitable for non-homogeneous lung pathologies where focal coalescence is possible. We therefore compared longitudinal vs. transversal scan and also cLUSS (standard coalescence-based LUSS) vs. qLUSS (quantitative LUSS based on % of involved pleura). Materials and methods 38 ICU patients were examined in 12 thoracic areas in longitudinal and transversal scan. B lines (number, coalescence), subpleural consolidations (SP), pleural length and pleural involvement (> or ≤50%) were assessed. cLUSS and qLUSS were computed in longitudinal and transversal scan. Results Transversal scan visualized wider (3.9 [IQR 3.8-3.9] vs 2.0 [1.6-2.5] cm, p<0.0001) and more constant (variance 0.02 vs 0.34cm, p<0.0001) pleural length, more B lines (70 vs 59% of scans, p<0.0001), coalescence (39 vs 28%, p<0.0001) and SP (22 vs 14%, p<0.0001) compared to longitudinal scan. Pleural involvement >50% was observed in 17% and coalescence in 33% of cases. Focal coalescence accounted for 52% of cases of coalescence. qLUSS-transv generated a different distribution of aeration scores compared to cLUSS-long (p<0.0001). Conclusion In unselected ICU patients, variability of pleural length in longitudinal scans is high and focal coalescence is frequent. Transversal scan and quantification of pleural involvement are simple measures to overcome these limitations of LUSS.
KW - lung aeration assessment
KW - lung aeration monitoring
KW - lung ultrasound
KW - lung ultrasound score
UR - http://www.scopus.com/inward/record.url?scp=85015234056&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85015234056&partnerID=8YFLogxK
U2 - 10.1055/s-0042-120260
DO - 10.1055/s-0042-120260
M3 - Article
AN - SCOPUS:85015234056
VL - 38
SP - 530
EP - 537
JO - Ultraschall in der Medizin
JF - Ultraschall in der Medizin
SN - 0172-4614
IS - 5
ER -