Comparison of 6-Point vs. 12-Point Lung Ultrasound for the Diagnosis of Bilateral Lung Infiltrates in ARDS

Abstract

Background:

Lung ultrasound is important for evaluating critically ill patients. For the identification of ARDS, it has used as an alternative to chest radiography and computed tomography (Kigali Modification of the Berlin Definition). However, it is unknown if an abbreviated 6-point lung ultrasound scan will perform as well as a more comprehensive 12-point lung ultrasound scan.

Methods:

Observational study of patients who required noninvasive ventilation or invasive ventilation for hypoxemic respiratory failure, on ICU admission, from August 2014 to March 2017. Only the first admissions to ICU during the study period, for patients whose diagnosis of respiratory failure was within one week of a known clinical insult or new/worsening respiratory symptoms, not fully explained by heart failure or fluid overload were included for analysis.

Results:

Lung ultrasound was done at 6 points per hemithorax for the 12-point lung ultrasound scan. Of these 6 points, the findings of 3 points (anterior-superior, anterior-inferior, and lateral-inferior) were used to constitute a 6-point lung ultrasound scan. A diagnosis of bilateral lung infiltrates could be made if at least one point on each hemithorax had more than 2 B-lines or any consolidation.

Conclusions:

229 patients (ICU mortality 22.7%, hospital mortality 34.5%) had bilateral infiltrates using 12-point lung ultrasound. Of these patients, 142 (62.0%) patients had bilateral infiltrates using 6-point ultrasound.