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Neuteboom OB, Heldeweg ML, Pisani L, Smit MR, Lagrand WK, Cherpanath TG, Dondorp AM, Schultz MJ, Tuinman PR. Assessing Extravascular Lung Water in Critically Ill Patients Using Lung Ultrasound: A Systematic Review on Methodological Aspects in Diagnostic Accuracy Studies. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1557-1564. [PMID: 32253067 DOI: 10.1016/j.ultrasmedbio.2020.02.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/18/2020] [Accepted: 02/20/2020] [Indexed: 06/11/2023]
Abstract
Lung ultrasound (LUS) is a non-invasive bedside method used to quantify extravascular lung water (EVLW). To evaluate the methodology and diagnostic accuracy of LUS in studies assessing EVLW in intensive care unit patients, PubMed and Embase were searched for studies comparing LUS with imaging modalities. In 14 relevant studies a wide variety of equipment used and training of examiners were noted. Four scoring systems were reported: (i) a binary score (the presence of three or more B-lines); (ii) a categorical score; (iii) a numerical score; (iv) a quantitative LUS score using software. The diagnostic accuracy of LUS varied: sensitivity ranged from 50%-98%, specificity from 76%-100% and r² from 0.20-0.91. Methodology and diagnostic accuracy varies substantially in published reports. Further research is needed to correlate methodological factors with diagnostic accuracy. Hospitals should standardize LUS methodology. Consensus is needed to harmonize LUS methodology for lung water assessment.
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Affiliation(s)
- Owen B Neuteboom
- Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Micah L Heldeweg
- Department of Intensive Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Luigi Pisani
- Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marry R Smit
- Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Wim K Lagrand
- Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Thomas G Cherpanath
- Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Arjen M Dondorp
- Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Laboratory of Experimental Intensive Care and Anesthesiology (L•E•I•C•A), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marcus J Schultz
- Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Laboratory of Experimental Intensive Care and Anesthesiology (L•E•I•C•A), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Mahidol-Oxford Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Pieter R Tuinman
- Department of Intensive Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Amsterdam Leiden IC Focused Echography (ALIFE), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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Karbing DS, Perchiazzi G, Rees SE, Jaffe MB. Journal of Clinical Monitoring and Computing 2018-2019 end of year summary: respiration. J Clin Monit Comput 2020; 34:197-205. [PMID: 31981067 PMCID: PMC7223067 DOI: 10.1007/s10877-020-00468-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 01/21/2020] [Indexed: 11/25/2022]
Abstract
This paper reviews 28 papers or commentaries published in Journal of Clinical Monitoring and Computing in 2018 and 2019, within the field of respiration. Papers were published covering endotracheal tube cuff pressure monitoring, ventilation and respiratory rate monitoring, lung mechanics monitoring, gas exchange monitoring, CO2 monitoring, lung imaging, and technologies and strategies for ventilation management.
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Affiliation(s)
- D S Karbing
- Respiratory and Critical Care Group (Rcare), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| | - G Perchiazzi
- Department of Surgical Sciences, The Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden
| | - S E Rees
- Respiratory and Critical Care Group (Rcare), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - M B Jaffe
- Cardiorespiratory Consulting, LLC, Cheshire, CT, USA
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