Lung Ultrasound in Patients with COVID-19

Abstract

COVID-19 je infektivna bolest koja se nakon pojave (prosinac 2019., Wuhan, Kina) tijekom sljedeća 3 mjeseca proširila na sve kontinente i izazvala pandemiju s kojom je čovječanstvo prvi put suočeno. S obzirom na to da bolesnici imaju pretežito respiratornu simptomatologiju često s razvojem intersticijske upale pluća te da se radi o visoko kontagioznoj bolesti, nameće se potreba brze, pouzdane i sigurne dijagnostike plućnih komplikacija ove bolesti. U COVID-19 bolesnika ciljani ultrazvuk pluća je superioran u odnosu na klasičnu Rtg snimku srca i pluća te se u dijagnostičkoj pouzdanosti približio MSCT-u toraksa. Razlog tomu je činjenica da su upalni infiltrati lokalizirani prvenstveno bazalno i periferno gdje su dostupni UZV pregledu. Najčešće zahvaćene regije su 5 i 6 obostrano, a u nalazu dominiraju multiple B linije u 2 i više regija u kombinaciji s pojedinačnim B linijama. U ožujku 2020. osnovan je Primarni respiracijsko-intenzivistički centar u KB Dubrava (PRIC KBD) s ciljem zbrinjavanja COVID-19 bolesnika s umjerenom do teškom kliničkom slikom i znacima respiracijske insuficijencije. Za dijagnostiku i praćenje bolesnika, uz Rtg snimku srca i pluća te MSCT toraksa, korišten je ciljani UZV pluća. Osim dobre korelacije s kliničkom slikom i stupnjem respiracijske insuficijencije, ciljani UZV pluća pokazao se korisnim zbog kratke izloženosti aerosolu tijekom pretrage, a bez potrebe za mobilizacijom bolesnika ili korištenjem mobilnog Rtg uređaja. Postao je suverena zamjena za stetoskop uz mogućnost pridržavanja svih mjera za prevenciju širenja aerosola: mobilni uređaj bez kabela, mogućnost dezinfekcije pa čak i korištenje samo jednog uređaja po bolesniku u intenzivističkom centru, čime je postao važna dijagnostička metoda kod COVID-19 pozitivnih bolesnika.COVID-19 is an infectious disease which surfaced in December 2019 (Wuhan, China) and swept across all the continents in a matter of 3 months, triggering a pandemic faced by humanity for the first time. Given the predominance of respiratory symptoms in patients, often accompanied by the development of interstitial pneumonia, and the fact that it is a highly contagious disease, it called for a prompt, reliable and safe diagnosis of pulmonary complications of the disease. In COVID-19 patients, focused lung ultrasound is superior to the classical heart or chest X-ray, and in terms of diagnostic reliability, is almost up to par to an MSCT of the thorax. This is due to the fact that inflammatory infiltrates are localized primarily basally and peripherally where they are accessible to ultrasound examinations. Regions 5 and 6 (both sides) are most commonly affected, and medical reports show a predominance of multiple B lines in 2 or more regions in combination with individual B lines. In March 2020, the Primary Respiratory Intensive Care Center at Clinical Hospital Dubrava (PRIC KBD) was founded to treat COVID-19 patients with a moderate to severe clinical picture and signs of respiratory failure. In addition to an X-ray of the heart and lungs and MSCT of the thorax, patients were diagnosed and monitored using focused lung ultrasound. Besides a good correlation with the clinical picture and degree of respiratory failure, focused lung ultrasound has shown to be favorable due to short aerosol exposure during screening, without the need to mobilize patients or use a mobile X-ray device. It has become an unrivalled replacement for the stethoscope, capable of adhering to all measures to prevent the spread of aerosols: a cordless mobile device, disinfectable, with even the ability to use only one device per patient in the intensive care unit, rendering it an important diagnostic tool in COVID-19 positive patients

    Similar works