Combined ultrasound-CT approach to monitor acute exacerbation of interstitial lung disease.

ECMO High-resolution CT Interstitial lung disease Lung monitoring Lung ultrasound

Journal

The ultrasound journal
ISSN: 2524-8987
Titre abrégé: Ultrasound J
Pays: Italy
ID NLM: 101742146

Informations de publication

Date de publication:
15 May 2020
Historique:
received: 05 02 2020
accepted: 02 05 2020
entrez: 16 5 2020
pubmed: 16 5 2020
medline: 16 5 2020
Statut: epublish

Résumé

Lung ultrasound is a bedside non-irradiating tool for assessment and monitoring of lung diseases. A lung ultrasound score based on visualized artefacts allows reliable quantification of lung aeration, and is useful to monitor mechanical ventilation setting, fluid resuscitation and antibiotic response in critical care. In the context of interstitial lung diseases associated to connective tissue disorders, lung ultrasound has been integrated to computed tomography for diagnosis and follow-up monitoring of chronic lung disease progression. This case describes a severe acute exacerbation of interstitial lung disease associated to dermatomyositis-polymyositis requiring prolonged extra-corporeal life support. Lung ultrasound score was performed daily and allowed monitoring and guiding both the need of advanced imaging as computed tomography and immunosuppressive therapy. This case suggests lung ultrasound may be a useful monitoring tool for the response to immunosuppressive therapy in acute severe rheumatic interstitial lung disease, where chest X-ray is poorly informative, and transportation is at high risk.

Sections du résumé

BACKGROUND BACKGROUND
Lung ultrasound is a bedside non-irradiating tool for assessment and monitoring of lung diseases. A lung ultrasound score based on visualized artefacts allows reliable quantification of lung aeration, and is useful to monitor mechanical ventilation setting, fluid resuscitation and antibiotic response in critical care. In the context of interstitial lung diseases associated to connective tissue disorders, lung ultrasound has been integrated to computed tomography for diagnosis and follow-up monitoring of chronic lung disease progression.
CASE PRESENTATION METHODS
This case describes a severe acute exacerbation of interstitial lung disease associated to dermatomyositis-polymyositis requiring prolonged extra-corporeal life support. Lung ultrasound score was performed daily and allowed monitoring and guiding both the need of advanced imaging as computed tomography and immunosuppressive therapy.
CONCLUSIONS CONCLUSIONS
This case suggests lung ultrasound may be a useful monitoring tool for the response to immunosuppressive therapy in acute severe rheumatic interstitial lung disease, where chest X-ray is poorly informative, and transportation is at high risk.

Identifiants

pubmed: 32409952
doi: 10.1186/s13089-020-00174-7
pii: 10.1186/s13089-020-00174-7
pmc: PMC7224726
doi:

Types de publication

Journal Article

Langues

eng

Pagination

27

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Auteurs

Silvia Mongodi (S)

Anaesthesia and Intensive Care, San Matteo Hospital, Viale Golgi 19, Pavia, Italy. silvia.mongodi@libero.it.

Andrea Colombo (A)

Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, Unit of Anaesthesia and Intensive Care, University of Pavia, Pavia, Italy.

Anita Orlando (A)

Anaesthesia and Intensive Care, San Matteo Hospital, Viale Golgi 19, Pavia, Italy.

Lorenzo Cavagna (L)

Division of Rheumatology, University of Pavia, San Matteo Hospital, Pavia, Italy.

Bélaid Bouhemad (B)

Dijon and Université Bourgogne Franche-Comté LNC UMR866, F-21000 Dijon, BP 77908, Dijon Cedex, 21709, France.
Department of Anesthesiology and Intensive Care, C.H.U. Dijon, Dijon Cedex, France.

Giorgio Antonio Iotti (GA)

Anaesthesia and Intensive Care, San Matteo Hospital, Viale Golgi 19, Pavia, Italy.
Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, Unit of Anaesthesia and Intensive Care, University of Pavia, Pavia, Italy.

Francesco Mojoli (F)

Anaesthesia and Intensive Care, San Matteo Hospital, Viale Golgi 19, Pavia, Italy.
Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, Unit of Anaesthesia and Intensive Care, University of Pavia, Pavia, Italy.

Classifications MeSH