Standardized protocol for ultrasound diagnosis of the lungs with COVID-19

  • O.M. Safonova Kyiv City Clinical Hospital No 18, Kyiv, Ukraine
  • O.B. Dynnyk Institute of Elastography, Kyiv, Ukraine https://orcid.org/0000-0001-8066-631X
  • G.L. Gumeniuk National University of Health of Ukraine named after P.L. Shupyk; SI “National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky of the NAMS of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0001-8160-7856
  • V.A. Lukiianchuk SI “Institute of Neurology, Psychiatry and Narcology of the NAMS of Ukraine”, Kharkiv, Ukraine https://orcid.org/0000-0003-2415-0428
  • H.V. Linska SI “Institute of Neurology, Psychiatry and Narcology of the NAMS of Ukraine”, Kharkiv, Ukraine
  • M.S. Brovchenko Kyiv City Clinical Hospital No 18, Kyiv, Ukraine
  • V.V. Panasiuk Kyiv City Clinical Hospital No 18, Kyiv, Ukraine
  • S.O. Soliaryk Kyiv City Clinical Hospital No 4, Kyiv, Ukraine

Abstract

BACKGROUND. The era of coronavirus disease (COVID-19) set the such task for lung ultrasound (LUS): to identify the presence of COVID-pneumonia, its differential diagnosis with other conditions which characterized by interstitial edema, determining the severity of lung damage and its location, the dynamics of pulmonary changes tissue, the development of complications, as well as to assess the effectiveness of personalized therapy.

OBJECTIVE. To develop a national LUS protocol for COVID-19 based on a balance of completeness of information with the optimal minimum of time and effort for medical staff, who often do not specialize in ultrasound using, with ultrasound equipment of basic and middle classes.

MATERIALS AND METHODS. A total of 1576 patients with COVID-19 were examined. There were 810 women (51.4 %) and 766 men (48.6 %). The age of the examined patients was in the range of 18-83 years, the average age was 52.3±14.6 years. 4710 LUS were performed, of which 1572 were repeated and 3144 – in the dynamics. Polysystemic ultrasound was performed in 275 patients. Ultrasound devices of both domestic and foreign production were used: Soneus P7 (Ultrasine, Ukraine), HandyUsound (Ukraine), Xario, USAP-770A (Toshiba, Japan), GE Venue (General Electric, USA) and TE7 COVID (Mindray, China) with ultrasound probes of convex, linear and microconvex formats.

RESULTS. Summarizing our own experience with patients with COVID-19 in 2020-2021, we have developed a version of the LUS-protocol, which has a convenient form of recording all stages of ultrasound with maximum coverage of the entire volume of both lungs according to a clear algorithm, a graphical form, clear ultrasound semiotics and diagnostic scoring criteria for the severity of lung damage.

CONCLUSIONS. 1. Clinical data indicate the feasibility and effectiveness of using LUS for dynamic monitoring of patients with pneumonia caused by SARS-CoV-2, especially in oxygen-dependent patients at their bedside (POCUS principle). 2. Optimization of the use of radiological diagnostic methods due to ultrasound makes it possible to reduce the radiation dose of the patient.3. The use of LUS allows more adequate decision-making on the need for intensive and interventional therapy, leads to faster diagnosis, improved medical care, reduced length of stay of patients in ICU, as well as reducing the total cost of treatment.4. Ability to reduce the impact of SARS-CoV-2 on healthcare professionals by limiting physical contact with the patient. 5. The standardized Ukrainian protocol of LUS provides availability, efficiency and clear interpretation of the received data at its use by different doctors in different medical institutions. The integration of the protocol in to the ultrasound machine provides optimization of the workflow process.

Keywords: ultrasound diagnostics of lungs, pulmonary ultrasound protocol, COVID-pneumonia, LUS, BLUE-protocol, POCUS.

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Published
2021-06-29
How to Cite
Safonova, O., Dynnyk, O., Gumeniuk, G., Lukiianchuk, V., Linska, H., Brovchenko, M., Panasiuk, V., & Soliaryk, S. (2021). Standardized protocol for ultrasound diagnosis of the lungs with COVID-19. Infusion & Chemotherapy, (2), 19-30. https://doi.org/10.32902/2663-0338-2021-2-19-30
Section
ORIGINAL STUDIES

Author Biographies

O.M. Safonova, Kyiv City Clinical Hospital No 18, Kyiv, Ukraine

Safonova Olha Mykolaivna
Doctor of Ultrasound Diagnostics of the Neurorehabilitation Department with Infectious Beds
17, T. Shevchenko blvd., Kyiv, 01030, Ukraine.

O.B. Dynnyk, Institute of Elastography, Kyiv, Ukraine

Dynnyk Oleh Borysovych
Medical Director; President of the Ukrainian Association of Ultrasound Diagnostics.
PhD.
7, Dilova st., Kyiv, 03150, Ukraine.

G.L. Gumeniuk, National University of Health of Ukraine named after P.L. Shupyk; SI “National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky of the NAMS of Ukraine”, Kyiv, Ukraine

Gumeniuk Galyna Lvivna
Professor of the Department of Tuberculosis and Pulmonology; Senior Researcher of Treatment, Diagnosis and Clinical Pharmacology of Lung Disease NIFP NAMNU.
MD, professor.
9, Dorohozhytska st., Kyiv, 04112, Ukraine.

V.A. Lukiianchuk, SI “Institute of Neurology, Psychiatry and Narcology of the NAMS of Ukraine”, Kharkiv, Ukraine

Lukiianchuk Vitaly A.
Anesthesiologist of the Department of Anesthesiology and Intensive Care.
17, Solomianska st., Kyiv, 03110, Ukraine.

H.V. Linska, SI “Institute of Neurology, Psychiatry and Narcology of the NAMS of Ukraine”, Kharkiv, Ukraine

Linska Hanna Volodymyrivna
Doctor of Ultrasound Diagnostics.
46, Akademika Pavlova st., Kharkiv, 61068, Ukraine.

M.S. Brovchenko, Kyiv City Clinical Hospital No 18, Kyiv, Ukraine

Brovchenko Marianna Stanislavivna
Head of the Department of Neurorehabilitation with Infectious Beds.
PhD.
17, T. Shevchenko blvd., Kyiv, 01030, Ukraine.

V.V. Panasiuk, Kyiv City Clinical Hospital No 18, Kyiv, Ukraine

Panasiuk Volodymyr Vasilovich
Head of the Department of Anesthesiology and Intensive Care.
17, T. Shevchenko blvd., Kyiv, 01030, Ukraine.

S.O. Soliaryk, Kyiv City Clinical Hospital No 4, Kyiv, Ukraine

Soliaryk Sergii Oleksandrovych
Head of the Department of Anesthesiology and Intensive Care.
PhD.
17, Solomianska st., Kyiv, 03110, Ukraine.