@article {Kong920, author = {Shuangshuang Kong and Jing Wang and Yuman Li and Ying Tian and Cheng Yu and Danqing Zhang and Hong Li and Li Zhang and Xueqin Pang and Mingxing Xie}, title = {Value of Bedside Lung Ultrasound in Severe and Critical COVID-19 Pneumonia}, volume = {66}, number = {6}, pages = {920--927}, year = {2021}, doi = {10.4187/respcare.08382}, publisher = {Respiratory Care}, abstract = {BACKGROUND: Lung ultrasound (LUS) is an effective imaging modality that can differentiate pathological lung from non-diseased lung. We aimed to explore the value of bedside LUS in patients with severe and critical coronavirus disease 2019 (COVID-19)-associated lung injury.METHODS: Sixty-three severe and 33 critical hospitalized subjects with COVID-19 were enrolled in this study. Bedside LUS was performed in all subjects; chest computed tomography was performed on the same day as bedside LUS in 23 cases. The LUS protocol consisted of 12 scanning zones. LUS score based on B-lines and lung consolidation was evaluated.RESULTS: The most common abnormality of LUS was the various forms of B-lines, detected in 93 (96.9\%) subjects; as the second most frequent abnormality, 80 (83.3\%) subjects exhibited lung consolidation, mainly located in the posterior lung region. Twenty-four (25.0\%) subjects had pleural line abnormalities, and 16 (16.7\%) had pleural effusion; 78 (81.3\%) subjects had >= 2 abnormal LUS patterns, and 93 (96.9\%) had bilateral lung involvement. The proportion of bilateral or unilateral lung consolidation and pleural effusion in the critical COVID-19 group were higher than that in the severe group (P \< .05). The lung consolidation of critical subjects showed a marked increase in most lung areas, including bilateral lateral lung, posterior lung, and left anterior-inferior lung area. The median (interquartile range) LUS scores of critical cases were higher than those of severe cases: left: 14 (12{\textendash}17) vs 7 (5{\textendash}12); right: 14 (10{\textendash}16) vs 8 (3{\textendash}12); bilateral: 28 (23{\textendash}31) vs 15 (8{\textendash}22) (P \< .001 for all). There was a good correlation between the LUS score and the chest computed tomography score (r = 0.887, P \< .001).CONCLUSIONS: The most common abnormal LUS pattern in subjects with severe and critical COVID-19 pneumonia was B-lines, followed by lung consolidation. Bedside LUS can provide important information for pulmonary involvement in patients with COVID-19.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/66/6/920}, eprint = {https://rc.rcjournal.com/content/66/6/920.full.pdf}, journal = {Respiratory Care} }