Point of care and intensive care lung ultrasound: A reference guide for practitioners during COVID-19

Radiography (Lond). 2020 Nov;26(4):e297-e302. doi: 10.1016/j.radi.2020.04.005. Epub 2020 Apr 17.

Abstract

Objectives: Current events with the recent COVID-19 outbreak are necessitating steep learning curves for the NHS workforce. Ultrasound, although not used in the diagnosis of COVID-19 may be utilised by practitioners at the point of care (POC) or on the intensive care units (ITUs) where rapid assessment of the lung condition may be required. The aim of this article was to review current literature surrounding the use of lung ultrasound in relation to COVID-19 and provide Sonographers with a quick and digestible reference guide for lung pathologies.

Key findings: Ultrasound is being used in Italy and China to help review lung condition during the COVID-19 outbreak however not strictly as a diagnostic tool as Computed Tomography (CT) of the chest and chest radiographs are currently gold standard. Ultrasound is highly sensitive in the detection of multiple lung pathologies which can be demonstrated in conjunction with COVID-19 however to date there are no specific, nor pathognomonic findings which relate to COVID-19 on ultrasound.

Conclusion: Lung ultrasound is highly sensitive and can quickly and accurately review lung condition creating potential to assess for changes or resolution over time, especially in the ITU and POC setting. However it should not be used as a diagnostic tool for COVID-19 due to low specificity in relation to the virus.

Implications for practice: The adoption of lung ultrasound to monitor lung condition during the COVID-19 outbreak may reduce the need for serial exposure to ionising radiation on the wards and in turn reduce the number of radiographers required to attend infected wards and bays, protecting both patients and the workforce.

Keywords: COVID-19; ITU; Intensive care; Lung ultrasound; POCUS; Point of care ultrasound.

Publication types

  • Review

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / diagnostic imaging*
  • Critical Care / methods*
  • Humans
  • Lung / diagnostic imaging*
  • Pandemics
  • Pneumonia, Viral / diagnostic imaging*
  • Point-of-Care Systems*
  • SARS-CoV-2
  • Ultrasonography / methods*