Open AccessInterstitial lung opacities in patients with severe COVID-19 pneumonia by bedside high-resolution ultrasound in association to CO2 retention
Author(s) -
G Peschel,
Ernst Michael Jung,
Christoph Fisser,
Franz Josef Putz,
Tobias Wertheimer,
Barbara Sinner,
Dirk Lunz,
F. Jung,
Martina Müller
Publication year - 2021
Publication title -
clinical hemorheology and microcirculation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 54
eISSN - 1875-8622
pISSN - 1386-0291
DOI - 10.3233/ch-200925
Subject(s) - ards , medicine , pneumonia , supine position , lung , mechanical ventilation , covid-19 , ventilation (architecture) , nuclear medicine , cardiology , gastroenterology , surgery , disease , mechanical engineering , infectious disease (medical specialty) , engineering
BACKGROUND: Coronavirus disease 2019 (COVID-19) can cause acute respiratory distress syndrome (ARDS). OBJECTIVE: This single centre cross-section study aimed to grade the severity of pneumonia by bed-side lung ultrasound (LUS). METHODS: A scoring system discriminates 5 levels of lung opacities: A-lines (0 points),≥3 B-line (1 point), coalescent B-lines (2 points), marked pleural disruptions (3 points), consolidations (4 points). LUS (convex 1–5 MHz probe) was performed at 6 defined regions for each hemithorax either in supine or prone position. A lung aeration score (LAS, maximum 4 points) was allocated for each patient by calculating the arithmetic mean of the examined lung areas. Score levels were correlated with ventilation parameters and laboratory markers. RESULTS: LAS of 20 patients with ARDS reached from 2.58 to 3.83 and was highest in the lateral right lobe (Mean 3.67). Ferritin levels (Mean 1885μg/l; r = 0.467; p = 0.051) showed moderate correlation in spearman roh calculation. PaCO2 level (Mean 46.75 mmHg; r = 0.632; p = 0.005) correlated significantly with LAS, while duration of ventilation, Horovitz index, CRP, LDH and IL-6 did not. CONCUSIONS: The proposed LAS describes severity of lung opacities in COVID-19 patients and correlates with CO2 retention in patients with ARDS.