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Review
. 2020 Aug;75(8):1096-1104.
doi: 10.1111/anae.15082. Epub 2020 Apr 28.

Point-of-care lung ultrasound in patients with COVID-19 - a narrative review

M J Smith  1 , S A Hayward  2 , S M Innes  3 , A S C Miller  4
Affiliations
Review

Point-of-care lung ultrasound in patients with COVID-19 - a narrative review

M J Smith et al. Anaesthesia. 2020 Aug.

Abstract
in English, Korean

Ultrasound imaging of the lung and associated tissues may play an important role in the management of patients with COVID-19-associated lung injury. Compared with other monitoring modalities, such as auscultation or radiographic imaging, we argue lung ultrasound has high diagnostic accuracy, is ergonomically favourable and has fewer infection control implications. By informing the initiation, escalation, titration and weaning of respiratory support, lung ultrasound can be integrated into COVID-19 care pathways for patients with respiratory failure. Given the unprecedented pressure on healthcare services currently, supporting and educating clinicians is a key enabler of the wider implementation of lung ultrasound. This narrative review provides a summary of evidence and clinical guidance for the use and interpretation of lung ultrasound for patients with moderate, severe and critical COVID-19-associated lung injury. Mechanisms by which the potential lung ultrasound workforce can be deployed are explored, including a pragmatic approach to training, governance, imaging, interpretation of images and implementation of lung ultrasound into routine clinical practice.

폐와 주변 조직의 초음파 영상은 COVID‐19와 관련된 폐 손상 환자 관리에 중요한 역할을 할 수 있다. 폐 초음파는 청 진 또는 방사선 촬영과 같은 다른 모니터링 방식과 비교하였 을 때 진단의 정확도가 높고, 인체공학적으로 유리하며, 감염 관리 문제점이 적다. 환기 보조의 시작, 증가, 감소 및 이탈 시 점을 알려줌으 로써 폐 초음파는 호흡 부전 환자 를 위한 COVID‐19 관리에 통합될 수 있다. 현재 의료 서비스에 가해 지는 전례 없는 압력을 감안할 때, 임상 의사에 대한 지원 및 교육은 폐 초음파를 보다 폭넓게 구현하기 위하여 꼭 필요하 다. 본 담화적 리뷰는 중등증, 중증 및 치명적인 COVID‐19 관 련 폐 손상 환자에서 폐 초음파 사용 및 해석을 위한 증거와 임상 지침의 요약을 제공하였다. 훈련, 거버넌스, 이미징, 영상 해석 및 임상에서 폐 초음파의 구현을 위한 실용적인 접근법 을 포함하여 폐 초음파를 다룰 수 있는 잠재적인 인력인이 배 치될 수 있는 메커니즘을 탐구하였다.

Keywords: COVID-19; lung ultrasound; point-of-care ultrasound; training; workforce.

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Figures

Figure 1
Figure 1
Sonographic characteristics of moderate, severe and critical pleural and parenchymal changes in patients with COVID‐19. [Colour figure can be viewed at wileyonlinelibrary.com]
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