Diaphragmatic Point-of-Care Ultrasound in COVID-19 Patients in the Emergency Department—A Proof-of-Concept Study

Background: Lung Ultrasound Evaluation (LUS) is usefully applied in the Emergency Department (ED) to patients with suspected or confirmed COVID-19. Diaphragmatic Ultrasound (DUS) may provide additional insight into ventilatory function. This proof-of-concept study aimed to evaluate the feasibility o...

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Autores principales:	Emanuele Pivetta, Irene Cara, Giulia Paglietta, Virginia Scategni, Giulia Labarile, Maria Tizzani, Giulio Porrino, Stefania Locatelli, Gilberto Calzolari, Fulvio Morello, Milena Maria Maule, Enrico Lupia
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	point-of-care ultrasound diaphragm COVID-19 Medicine R
Acceso en línea:	https://doaj.org/article/ed05c2e2a85340388a146651b8dd1e0a
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spelling	oai:doaj.org-article:ed05c2e2a85340388a146651b8dd1e0a2021-11-25T18:01:28ZDiaphragmatic Point-of-Care Ultrasound in COVID-19 Patients in the Emergency Department—A Proof-of-Concept Study10.3390/jcm102252912077-0383https://doaj.org/article/ed05c2e2a85340388a146651b8dd1e0a2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5291https://doaj.org/toc/2077-0383Background: Lung Ultrasound Evaluation (LUS) is usefully applied in the Emergency Department (ED) to patients with suspected or confirmed COVID-19. Diaphragmatic Ultrasound (DUS) may provide additional insight into ventilatory function. This proof-of-concept study aimed to evaluate the feasibility of LUS and DUS in a third level ED during the COVID-19 pandemic. Methods: Adult patients presenting with COVID-19 symptoms were eligible. After the physical examination, both LUS and DUS (i.e., diaphragmatic motion and thickness) were performed. All patients were followed after 30 days to determine their need for ventilation, admission, and/or a new ED evaluation after discharge. The diagnostic accuracies of diaphragm measurements in assessing the risk of the 30-day outcome were calculated as well as the measurements’ usefulness. Bland–Altman plots were used for comparing bedside and off-line diaphragm measurements. Results: 118 patients were enrolled. Median thickness and motion were 1.7 mm (iqr 0.4) and 1.8 cm (iqr 0.7), respectively, with a mean difference of 0.009 mm (95% CI −0.037–0.056 mm) and −0.051 cm (95% CI −0.108–0.006 cm), respectively. The 30-day outcome was associated with an increase in thickness (OR 5.84, 95% CI 0.96–35.4), and a lower motion (OR 0.49, 95% CI 0.2–1.21). Conclusion: DUS seemed to be feasible and reliable in the ED in a population of patients presenting with symptoms related to COVID-19 infection.Emanuele PivettaIrene CaraGiulia PagliettaVirginia ScategniGiulia LabarileMaria TizzaniGiulio PorrinoStefania LocatelliGilberto CalzolariFulvio MorelloMilena Maria MauleEnrico LupiaMDPI AGarticlepoint-of-care ultrasounddiaphragmCOVID-19MedicineRENJournal of Clinical Medicine, Vol 10, Iss 5291, p 5291 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	point-of-care ultrasound diaphragm COVID-19 Medicine R
spellingShingle	point-of-care ultrasound diaphragm COVID-19 Medicine R Emanuele Pivetta Irene Cara Giulia Paglietta Virginia Scategni Giulia Labarile Maria Tizzani Giulio Porrino Stefania Locatelli Gilberto Calzolari Fulvio Morello Milena Maria Maule Enrico Lupia Diaphragmatic Point-of-Care Ultrasound in COVID-19 Patients in the Emergency Department—A Proof-of-Concept Study
description	Background: Lung Ultrasound Evaluation (LUS) is usefully applied in the Emergency Department (ED) to patients with suspected or confirmed COVID-19. Diaphragmatic Ultrasound (DUS) may provide additional insight into ventilatory function. This proof-of-concept study aimed to evaluate the feasibility of LUS and DUS in a third level ED during the COVID-19 pandemic. Methods: Adult patients presenting with COVID-19 symptoms were eligible. After the physical examination, both LUS and DUS (i.e., diaphragmatic motion and thickness) were performed. All patients were followed after 30 days to determine their need for ventilation, admission, and/or a new ED evaluation after discharge. The diagnostic accuracies of diaphragm measurements in assessing the risk of the 30-day outcome were calculated as well as the measurements’ usefulness. Bland–Altman plots were used for comparing bedside and off-line diaphragm measurements. Results: 118 patients were enrolled. Median thickness and motion were 1.7 mm (iqr 0.4) and 1.8 cm (iqr 0.7), respectively, with a mean difference of 0.009 mm (95% CI −0.037–0.056 mm) and −0.051 cm (95% CI −0.108–0.006 cm), respectively. The 30-day outcome was associated with an increase in thickness (OR 5.84, 95% CI 0.96–35.4), and a lower motion (OR 0.49, 95% CI 0.2–1.21). Conclusion: DUS seemed to be feasible and reliable in the ED in a population of patients presenting with symptoms related to COVID-19 infection.
format	article
author	Emanuele Pivetta Irene Cara Giulia Paglietta Virginia Scategni Giulia Labarile Maria Tizzani Giulio Porrino Stefania Locatelli Gilberto Calzolari Fulvio Morello Milena Maria Maule Enrico Lupia
author_facet	Emanuele Pivetta Irene Cara Giulia Paglietta Virginia Scategni Giulia Labarile Maria Tizzani Giulio Porrino Stefania Locatelli Gilberto Calzolari Fulvio Morello Milena Maria Maule Enrico Lupia
author_sort	Emanuele Pivetta
title	Diaphragmatic Point-of-Care Ultrasound in COVID-19 Patients in the Emergency Department—A Proof-of-Concept Study
title_short	Diaphragmatic Point-of-Care Ultrasound in COVID-19 Patients in the Emergency Department—A Proof-of-Concept Study
title_full	Diaphragmatic Point-of-Care Ultrasound in COVID-19 Patients in the Emergency Department—A Proof-of-Concept Study
title_fullStr	Diaphragmatic Point-of-Care Ultrasound in COVID-19 Patients in the Emergency Department—A Proof-of-Concept Study
title_full_unstemmed	Diaphragmatic Point-of-Care Ultrasound in COVID-19 Patients in the Emergency Department—A Proof-of-Concept Study
title_sort	diaphragmatic point-of-care ultrasound in covid-19 patients in the emergency department—a proof-of-concept study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/ed05c2e2a85340388a146651b8dd1e0a
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Diaphragmatic Point-of-Care Ultrasound in COVID-19 Patients in the Emergency Department—A Proof-of-Concept Study

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