Respiratory failure & ventilation
Lung ultrasound to predict gas-exchange response to prone positioning in COVID-19 patients: A prospective study in pilot and confirmation cohorts
Authors' conclusion
Anterior LUSI, in addition to other clinical parameters, may be used to aid COVID-19 respiratory strategy and a clinician's decision to prone.
Study context
- Population
- Critically ill COVID-19 patients undergoing prone positioning
- Participants
- 79 patients
- Exposure
- Pilot vs Confirmation
- Pilotn = 36
- Confirmationn = 43
- Outcome
- Gas-exchange response (change in PaO2/FiO2) after prone positioning, predicted by pre-turn lung ultrasound
Methodological detailspilot and confirmation cohorts
- Pilot and confirmation cohorts
Main finding
As reported in the abstract
Correlation of pre-turn lung ultrasound score index (LUSI) with change in PaO2/FiO2 after prone positioning
- Pilot cohort: moderate correlation between pre-turn lung ultrasound score index (LUSI) and change in PaO2/FiO2 after prone positioning
- Confirmation cohort: findings corroborated; anterior LUSI had the strongest correlation at 1, 6, 12 and 24 h after prone positioning, strength increasing up to 24 h
Observational data: associations, not effects.
Further findings
Predictors of PaO2/FiO2 increase ≥20 mmHg (multivariate model)
| OR (95% CI) | ||
|---|---|---|
| Anterior LUSI >50%Negatively predictive | 0.035 (0.003–0.319) | |
| Higher pre-turn PaCO2Negatively predictive | 0.479 (0.235–0.979) | |
| 0.050.21520Odds ratio (log scale) |
Original publication
Lung ultrasound to predict gas-exchange response to prone positioning in COVID-19 patients: A prospective study in pilot and confirmation cohorts. J Crit Care. Published 18 October 2022. doi:10.
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