Lung ultrasound is associated with distinct clinical phenotypes in COVID-19 ARDS: A retrospective observational study.
PLoS One
; 19(6): e0304508, 2024.
Article
em En
| MEDLINE
| ID: mdl-38829891
ABSTRACT
BACKGROUND:
ARDS is a heterogeneous syndrome with distinct clinical phenotypes. Here we investigate whether the presence or absence of large pulmonary ultrasonographic consolidations can categorize COVID-19 ARDS patients requiring mechanical ventilation into distinct clinical phenotypes.METHODS:
This is a retrospective study performed in a tertiary-level intensive care unit in Israel between April and September 2020. Data collected included lung ultrasound (LUS) findings, respiratory parameters, and treatment interventions. The primary outcome was a composite of three ARDSinterventions:
prone positioning, high PEEP, or a high dose of inhaled nitric oxide.RESULTS:
A total of 128 LUS scans were conducted among 23 patients. The mean age was 65 and about two-thirds were males. 81 scans identified large consolidation and were classified as "C-type", and 47 scans showed multiple B-lines with no or small consolidation and were classified as "B-type". The presence of a "C-type" study had 2.5 times increased chance of receiving the composite primary outcome of advanced ARDS interventions despite similar SOFA scores, Pao2/FiO2 ratio, and markers of disease severity (OR = 2.49, %95CI 1.40-4.44).CONCLUSION:
The presence of a "C-type" profile with LUS consolidation potentially represents a distinct COVID-19 ARDS subphenotype that is more likely to require aggressive ARDS interventions. Further studies are required to validate this phenotype in a larger cohort and determine causality, diagnostic, and treatment responses.
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Base de dados:
MEDLINE
Assunto principal:
Fenótipo
/
Síndrome do Desconforto Respiratório
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Ultrassonografia
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COVID-19
/
Pulmão
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article