LUNG

ULTRASOUND

KEVIN LUMOWA
ARTICLES

 Reference 1
 Pontis E, Claret PG, Markarian T, Javaudin F, Flacher A, Roger C, Muller L, et al. Integration of lung ultrasound in the
diagnostic reasoning in acute dyspneic patients: A prospective randomized study. Am J Emerg Med 2018;36(9):1597-1602.
 Reference 2
 Kim YS, Won YJ, Lee DK, Lim BG, Kim H, Lee IO, Yun JH, et al. Lung ultrasound score-based perioperative assessment of
pressure-controlled ventilation-volume guaranteed or volume-controlled ventilation in geriatrics: a prospective randomized
controlled trial. Clin Interv Aging 2019;14:1319-1329.
BACKGROUND

 Lung Ultrasound has many uses in different areas of the hospital, one of them being the emergency department.
 Aim: Identify the determinants of increasing diagnostic accuracy due to lung ultrasound in
complicated clinical cases of acute dyspnea.
 Lung ultrasound should be easily integratable by physicians to contribute to their clinical
reasoning. This adds on top to all the other factors that are included in a physician’s clinical
reasoning. The amount of weight that lung ultrasound has in diagnostic reasoning varies by
physician.
METHODS

 Multicentre, prospective, randomized study

 Four experts (3 emergency physicians, 1 critical care physician) participated. 3 clinical
scenarios of acute dyspnea were defined by them. One case only had clinical data, only only
had LUS data, and one had both. 
 For the cases, there were eight possible diagnoses: (look notes). The participants (n=76) had
to evaluate the diagnostic probability from 0 (unlikely definitely not diagnosis) to 10 (definite
diagnosis) for each diagnosis.
RESULTS
ARTICLE 2

 Hypothesis: The researchers hypothesized that PCV-VG may result in better LUS by reducing
atelectasis in the dependent area of the lung and minimizing respiratory deterioration during
the postoperative period in elderly patients
 The potential benefits of PCV-VG over VCV are controversial and not impressive. To quickly
and appropriately assess patients’ respiratory status during surgery, lung ultrasound could be
used.
METHODS

 Single-center prospective randomized controlled trial 

 Subjects were recruited from the department of orthopedic surgery. Those who weren’t
excluded were randomised into the PCV-VG group or the VCV group
 LUS and mechanical ventilator parameters were measured and evaluated before induction, 30
min after a position change, during supine repositioning before awakening, and 15 min after
arrival to the PACU. PFT’s were also performed preoperative and postoperative. 
 This data was collected to demonstrate and show the effects of PCV-VG and VCV in elderly
patients
RESULTS
COMPARE AND CONTRAST

Article 1
 Results showed that the higher frequency of ultrasound Article 2
use by physicians decreased the NUD in difficult clinical  Results showed that favor towards LUS, higher dynamic
cases with ultrasound data compliance, and low inspiratory pressure in the PCV-VG
 Methods section was confusing as to how they did their group compared to those in the VCV group
study.

Both studies utilized lung ultrasound uniquely for testing their hypotheses.
FUTURE DIRECTION

 Article 1
 Look into including respiratory therapists as practitioners for lung ultrasound at the bedside for research

 Article 2
 Look into different patient age populations and other areas of the hospital rather than just surgery, such as in
critical care/ICU.