Lung ultrasound score predicts outcomes in patients with acute respiratory failure secondary to COVID-19 treated with non-invasive respiratory support: a prospective cohort study
Abstract Background Lung ultrasound has demonstrated its usefulness in several respiratory diseases management. One derived score, the Lung Ultrasound (LUS) score, is considered a good outcome predictor in patients with Acute Respiratory Failure (ARF). Nevertheless, it has not been tested in patient...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2024-03-01
|
| Series: | The Ultrasound Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13089-024-00365-6 |
| _version_ | 1797266881479966720 |
|---|---|
| author | Mauro Castro-Sayat Nicolás Colaianni-Alfonso Luigi Vetrugno Gustavo Olaizola Cristian Benay Federico Herrera Yasmine Saá Guillermo Montiel Santiago Haedo Ignacio Previgliano Ada Toledo Catalina Siroti |
| author_facet | Mauro Castro-Sayat Nicolás Colaianni-Alfonso Luigi Vetrugno Gustavo Olaizola Cristian Benay Federico Herrera Yasmine Saá Guillermo Montiel Santiago Haedo Ignacio Previgliano Ada Toledo Catalina Siroti |
| author_sort | Mauro Castro-Sayat |
| collection | DOAJ |
| description | Abstract Background Lung ultrasound has demonstrated its usefulness in several respiratory diseases management. One derived score, the Lung Ultrasound (LUS) score, is considered a good outcome predictor in patients with Acute Respiratory Failure (ARF). Nevertheless, it has not been tested in patients undergoing non-invasive respiratory support (NIRS). Taking this into account, the aim of this study is to evaluate LUS score as a predictor of 90-day mortality, ETI (Endotracheal intubation) and HFNC (High Flow Nasal Cannula) failure in patients with ARF due to COVID-19 admitted to a Respiratory Intermediate Care Unit (RICU) for NIRS management. Results One hundred one patients were admitted to the RICU during the study period. Among these 76% were males and the median age was 55 (45–64) years. Initial ARF management started with HFNC, the next step was the use of Continuous Positive Airway Pressure (CPAP) devices and the last intervention was ETI and Intensive Care Unit (ICU) admission. Of the total study population, CPAP was required in 40%, ETI in 26%, while 15% died. By means of a ROC analysis, a LUS ≥ 25 points was identified as the cut-off point for mortality(AUC 0.81, OR 1.40, 95% CI 1.14 to 1.71; p < 0.001), ETI (AUC 0.83, OR 1.43, 95% CI 1.20 to 1.70; p < 0.001) and HFNC failure (AUC 0.75, OR 1.25, 95% CI 1.12 to 1.41; p < 0.001). Kaplan-Meier survival curves also identified LUS ≥ 25 as a predictor of 90-days mortality (HR 4.16, 95% CI 1.27–13.6) and 30 days ETI as well. Conclusion In our study, a ≥ 25 point cut-off of the Lung Ultrasound Score was identified as a good outcome prediction factor for 90-days mortality, ETI and HFNC failure in a COVID-19 ARF patients cohort treated in a RICU. Considering that LUS score is easy to calculate, a multicenter study to confirm our findings should be performed. |
| first_indexed | 2024-04-25T01:07:44Z |
| format | Article |
| id | doaj.art-fb4796597cd241329a410aa58247be3c |
| institution | Directory Open Access Journal |
| issn | 2524-8987 |
| language | English |
| last_indexed | 2024-04-25T01:07:44Z |
| publishDate | 2024-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Ultrasound Journal |
| spelling | doaj.art-fb4796597cd241329a410aa58247be3c2024-03-10T12:08:40ZengSpringerOpenThe Ultrasound Journal2524-89872024-03-011611810.1186/s13089-024-00365-6Lung ultrasound score predicts outcomes in patients with acute respiratory failure secondary to COVID-19 treated with non-invasive respiratory support: a prospective cohort studyMauro Castro-Sayat0Nicolás Colaianni-Alfonso1Luigi Vetrugno2Gustavo Olaizola3Cristian Benay4Federico Herrera5Yasmine Saá6Guillermo Montiel7Santiago Haedo8Ignacio Previgliano9Ada Toledo10Catalina Siroti11Respiratory Intermediate Care Unit, Juan A. Fernandez HospitalRespiratory Intermediate Care Unit, Juan A. Fernandez HospitalDepartment of Medical, Oral and Biotechnological Sciences, University of G. d’ AnnunzioHealthcare Unit Dr. Cesar MilsteinPolice Medical Complex Churruca-ViscaRespiratory Intermediate Care Unit, Juan A. Fernandez HospitalRespiratory Intermediate Care Unit, Juan A. Fernandez HospitalRespiratory Intermediate Care Unit, Juan A. Fernandez HospitalRespiratory Intermediate Care Unit, Juan A. Fernandez HospitalRespiratory Intermediate Care Unit, Juan A. Fernandez HospitalRespiratory Intermediate Care Unit, Juan A. Fernandez HospitalRespiratory Intermediate Care Unit, Juan A. Fernandez HospitalAbstract Background Lung ultrasound has demonstrated its usefulness in several respiratory diseases management. One derived score, the Lung Ultrasound (LUS) score, is considered a good outcome predictor in patients with Acute Respiratory Failure (ARF). Nevertheless, it has not been tested in patients undergoing non-invasive respiratory support (NIRS). Taking this into account, the aim of this study is to evaluate LUS score as a predictor of 90-day mortality, ETI (Endotracheal intubation) and HFNC (High Flow Nasal Cannula) failure in patients with ARF due to COVID-19 admitted to a Respiratory Intermediate Care Unit (RICU) for NIRS management. Results One hundred one patients were admitted to the RICU during the study period. Among these 76% were males and the median age was 55 (45–64) years. Initial ARF management started with HFNC, the next step was the use of Continuous Positive Airway Pressure (CPAP) devices and the last intervention was ETI and Intensive Care Unit (ICU) admission. Of the total study population, CPAP was required in 40%, ETI in 26%, while 15% died. By means of a ROC analysis, a LUS ≥ 25 points was identified as the cut-off point for mortality(AUC 0.81, OR 1.40, 95% CI 1.14 to 1.71; p < 0.001), ETI (AUC 0.83, OR 1.43, 95% CI 1.20 to 1.70; p < 0.001) and HFNC failure (AUC 0.75, OR 1.25, 95% CI 1.12 to 1.41; p < 0.001). Kaplan-Meier survival curves also identified LUS ≥ 25 as a predictor of 90-days mortality (HR 4.16, 95% CI 1.27–13.6) and 30 days ETI as well. Conclusion In our study, a ≥ 25 point cut-off of the Lung Ultrasound Score was identified as a good outcome prediction factor for 90-days mortality, ETI and HFNC failure in a COVID-19 ARF patients cohort treated in a RICU. Considering that LUS score is easy to calculate, a multicenter study to confirm our findings should be performed.https://doi.org/10.1186/s13089-024-00365-6COVID-19Acute respiratory failureUltrasonographyNon-invasive ventilation |
| spellingShingle | Mauro Castro-Sayat Nicolás Colaianni-Alfonso Luigi Vetrugno Gustavo Olaizola Cristian Benay Federico Herrera Yasmine Saá Guillermo Montiel Santiago Haedo Ignacio Previgliano Ada Toledo Catalina Siroti Lung ultrasound score predicts outcomes in patients with acute respiratory failure secondary to COVID-19 treated with non-invasive respiratory support: a prospective cohort study The Ultrasound Journal COVID-19 Acute respiratory failure Ultrasonography Non-invasive ventilation |
| title | Lung ultrasound score predicts outcomes in patients with acute respiratory failure secondary to COVID-19 treated with non-invasive respiratory support: a prospective cohort study |
| title_full | Lung ultrasound score predicts outcomes in patients with acute respiratory failure secondary to COVID-19 treated with non-invasive respiratory support: a prospective cohort study |
| title_fullStr | Lung ultrasound score predicts outcomes in patients with acute respiratory failure secondary to COVID-19 treated with non-invasive respiratory support: a prospective cohort study |
| title_full_unstemmed | Lung ultrasound score predicts outcomes in patients with acute respiratory failure secondary to COVID-19 treated with non-invasive respiratory support: a prospective cohort study |
| title_short | Lung ultrasound score predicts outcomes in patients with acute respiratory failure secondary to COVID-19 treated with non-invasive respiratory support: a prospective cohort study |
| title_sort | lung ultrasound score predicts outcomes in patients with acute respiratory failure secondary to covid 19 treated with non invasive respiratory support a prospective cohort study |
| topic | COVID-19 Acute respiratory failure Ultrasonography Non-invasive ventilation |
| url | https://doi.org/10.1186/s13089-024-00365-6 |
| work_keys_str_mv | AT maurocastrosayat lungultrasoundscorepredictsoutcomesinpatientswithacuterespiratoryfailuresecondarytocovid19treatedwithnoninvasiverespiratorysupportaprospectivecohortstudy AT nicolascolaiannialfonso lungultrasoundscorepredictsoutcomesinpatientswithacuterespiratoryfailuresecondarytocovid19treatedwithnoninvasiverespiratorysupportaprospectivecohortstudy AT luigivetrugno lungultrasoundscorepredictsoutcomesinpatientswithacuterespiratoryfailuresecondarytocovid19treatedwithnoninvasiverespiratorysupportaprospectivecohortstudy AT gustavoolaizola lungultrasoundscorepredictsoutcomesinpatientswithacuterespiratoryfailuresecondarytocovid19treatedwithnoninvasiverespiratorysupportaprospectivecohortstudy AT cristianbenay lungultrasoundscorepredictsoutcomesinpatientswithacuterespiratoryfailuresecondarytocovid19treatedwithnoninvasiverespiratorysupportaprospectivecohortstudy AT federicoherrera lungultrasoundscorepredictsoutcomesinpatientswithacuterespiratoryfailuresecondarytocovid19treatedwithnoninvasiverespiratorysupportaprospectivecohortstudy AT yasminesaa lungultrasoundscorepredictsoutcomesinpatientswithacuterespiratoryfailuresecondarytocovid19treatedwithnoninvasiverespiratorysupportaprospectivecohortstudy AT guillermomontiel lungultrasoundscorepredictsoutcomesinpatientswithacuterespiratoryfailuresecondarytocovid19treatedwithnoninvasiverespiratorysupportaprospectivecohortstudy AT santiagohaedo lungultrasoundscorepredictsoutcomesinpatientswithacuterespiratoryfailuresecondarytocovid19treatedwithnoninvasiverespiratorysupportaprospectivecohortstudy AT ignacioprevigliano lungultrasoundscorepredictsoutcomesinpatientswithacuterespiratoryfailuresecondarytocovid19treatedwithnoninvasiverespiratorysupportaprospectivecohortstudy AT adatoledo lungultrasoundscorepredictsoutcomesinpatientswithacuterespiratoryfailuresecondarytocovid19treatedwithnoninvasiverespiratorysupportaprospectivecohortstudy AT catalinasiroti lungultrasoundscorepredictsoutcomesinpatientswithacuterespiratoryfailuresecondarytocovid19treatedwithnoninvasiverespiratorysupportaprospectivecohortstudy |