Open AccessUsing lung ultrasound changes to evaluate the response of recruitment maneuver in a patient recovering from coronavirus disease 2019 with acute respiratory distress syndrome
Author(s) -
Yi-Han Hsiao,
Yi Tsung Lin,
Hsien Tzung Liao,
Kuang Yao Yang,
Yuh Min Chen
Publication year - 2020
Publication title -
journal of the chinese medical association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.535
H-Index - 42
eISSN - 1728-7731
pISSN - 1726-4901
DOI - 10.1097/jcma.0000000000000418
Subject(s) - medicine , ards , extracorporeal membrane oxygenation , lung ultrasound , covid-19 , acute respiratory distress , intensive care medicine , intensive care , lung , critically ill , pandemic , emergency medicine , disease , infectious disease (medical specialty)
Lung ultrasound (LUS) is widely used in intensive care units because it provides timely information noninvasively. The use of LUS is recommended to minimize transfers in critically ill patients with coronavirus disease 2019 (COVID-19) during the pandemic. The clinical efficacies of bedside chest X-ray (CXR) and LUS have not been compared in these patients. Herein, we demonstrated serial LUS changes in a 75-year-old woman recovering from COVID-19 with acute respiratory distress syndrome (ARDS) in need of veno-venous extracorporeal membrane oxygenation support. LUS initially revealed extensive consolidation in the bilateral lower lung (BLL) fields with coalescent B-lines. While the patient recovered from ARDS, the findings gradually changed to discrete B-lines and small pleural consolidations. The LUS findings were more sensitive than those of the CXR in detecting re-expansion of the lungs by showing B-lines instead of consolidations in the BLL fields immediately after recruitment maneuver (RM). Compared with physiological parameters, LUS findings provided more precise information about the parts of the lungs that had been recruited by RM. Therefore, we encourage intensivists to extend their use of LUS in critically ill patients with COVID-19 and ARDS to acquire real-time information for a quick response and minimize the risk of viral transmission.