Respiratory failure & ventilation
Tracking pleural sliding motion to assess lung overdistention using an open source algorithm: a proof-of-concept study on lung ultrasound scans
Authors' conclusion
Pleural line motion tracking is feasible and provides quantitative insight into pleural movement based on data from healthy volunteers and visual inspection of images from ICU patients. Moreover, pleural line movement allows accurate assessment of overdistention during mechanical ventilation when compared with electrical-impedance tomography.
Study context
- Population
- Healthy volunteers, ICU patients, and severe COVID-19 pneumonia patients undergoing PEEP titration; lung ultrasound video clips
- Participants
- 7 / 40 / 30
- Comparison
- Pleural line (PL) movement across breathing states, lung sliding grades and PEEP levels
- Healthy volunteersn = 7
- ICUn = 40
- Severe COVID-19n = 30
- Outcome
- PL movement (maximum lateral movement on the transversal plane among three normalized PL landmarks)
Methodological detailsopen-source motion tracking algorithm (Channel and Spatial Reliability Tracking)
- Open-source motion tracking algorithm (Channel and Spatial Reliability Tracking)
Main finding
As reported in the abstract
P < 0.01
Further findings
PL movement by lung sliding grade, ICU patients (336 video clips)
P < 0.01
- PL movement by lung sliding grade, ICU patients (336 video clips) — Ordered logistic regression predicted Absent sliding, balanced accuracy
- 71%
PL movement by lung sliding grade, ICU patients (336 video clips)
- No patients without lung sliding misclassified as extensive
Overdistention (electrical-impedance tomography) vs PL movement, PEEP titration (358 video clips)
- Spearman-rho
- −0.6
- PL movement decreased from low to high PEEP levels
- P < 0.01
Original publication
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