Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care expert consensus statement on the use of lung ultrasound in critically ill patients with coronavirus disease 2019 (ITACO).

Consensus Coronavirus disease 2019 Intensive care Lung ultrasound

Journal

Journal of anesthesia, analgesia and critical care
ISSN: 2731-3786
Titre abrégé: J Anesth Analg Crit Care
Pays: England
ID NLM: 9918591885906676

Informations de publication

Date de publication:
24 Nov 2021
Historique:
received: 20 10 2021
accepted: 25 10 2021
medline: 24 11 2021
pubmed: 24 11 2021
entrez: 29 6 2023
Statut: epublish

Résumé

To produce statements based on the available evidence and an expert consensus (as members of the Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care, SIAARTI) on the use of lung ultrasound for the management of patients with COVID-19 admitted to the intensive care unit. A modified Delphi method was applied by a panel of anesthesiologists and intensive care physicians expert in the use of lung ultrasound in COVID-19 intensive critically ill patients to reach a consensus on ten clinical questions concerning the role of lung ultrasound in the following: COVID-19 diagnosis and monitoring (with and without invasive mechanical ventilation), positive end expiratory pressure titration, the use of prone position, the early diagnosis of pneumothorax- or ventilator-associated pneumonia, the process of weaning from invasive mechanical ventilation, and the need for radiologic chest imaging. A total of 20 statements were produced by the panel. Agreement was reached on 18 out of 20 statements (scoring 7-9; "appropriate") in the first round of voting, while 2 statements required a second round for agreement to be reached. At the end of the two Delphi rounds, the median score for the 20 statements was 8.5 [IQR 8.9], and the agreement percentage was 100%. The Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care produced 20 consensus statements on the use of lung ultrasound in COVID-19 patients admitted to the ICU. This expert consensus strongly suggests integrating lung ultrasound findings in the clinical management of critically ill COVID-19 patients.

Sections du résumé

BACKGROUND BACKGROUND
To produce statements based on the available evidence and an expert consensus (as members of the Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care, SIAARTI) on the use of lung ultrasound for the management of patients with COVID-19 admitted to the intensive care unit.
METHODS METHODS
A modified Delphi method was applied by a panel of anesthesiologists and intensive care physicians expert in the use of lung ultrasound in COVID-19 intensive critically ill patients to reach a consensus on ten clinical questions concerning the role of lung ultrasound in the following: COVID-19 diagnosis and monitoring (with and without invasive mechanical ventilation), positive end expiratory pressure titration, the use of prone position, the early diagnosis of pneumothorax- or ventilator-associated pneumonia, the process of weaning from invasive mechanical ventilation, and the need for radiologic chest imaging.
RESULTS RESULTS
A total of 20 statements were produced by the panel. Agreement was reached on 18 out of 20 statements (scoring 7-9; "appropriate") in the first round of voting, while 2 statements required a second round for agreement to be reached. At the end of the two Delphi rounds, the median score for the 20 statements was 8.5 [IQR 8.9], and the agreement percentage was 100%.
CONCLUSION CONCLUSIONS
The Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care produced 20 consensus statements on the use of lung ultrasound in COVID-19 patients admitted to the ICU. This expert consensus strongly suggests integrating lung ultrasound findings in the clinical management of critically ill COVID-19 patients.

Identifiants

pubmed: 37386555
doi: 10.1186/s44158-021-00015-6
pii: 10.1186/s44158-021-00015-6
pmc: PMC8611396
doi:

Types de publication

Journal Article

Langues

eng

Pagination

16

Informations de copyright

© 2021. The Author(s).

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Auteurs

Luigi Vetrugno (L)

Department of Medicine, University of Udine, Via Colugna n 50, 33100, Udine, Italy. luigi.vetrugno@uniud.it.
University-Hospital of Friuli Centrale, ASU FC, Udine, Italy. luigi.vetrugno@uniud.it.

Francesco Mojoli (F)

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

Andrea Cortegiani (A)

Department of Surgical, Oncological and Oral Science (Di.Chir.On.S), University of Palermo, Palermo, Italy.
Department of Anesthesia Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy.

Elena Giovanna Bignami (EG)

Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Parma, Italy.

Mariachiara Ippolito (M)

Department of Surgical, Oncological and Oral Science (Di.Chir.On.S), University of Palermo, Palermo, Italy.
Department of Anesthesia Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy.

Daniele Orso (D)

University-Hospital of Friuli Centrale, ASU FC, Udine, Italy.

Francesco Corradi (F)

Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
Department of Anesthesia and Intensive Care, "Ente Ospedaliero Ospedali Galliera", Genova, Italy.

Gianmaria Cammarota (G)

Department of Medicine and Surgery, University of Perugia, Perugia, Italy.

Silvia Mongodi (S)

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

Enrico Boero (E)

Anesthesia and Intensive Care Unit, San Giovanni Bosco Hospital, Turin, Italy.

Carmine Iacovazzo (C)

Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.

Maria Vargas (M)

Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.

Daniele Poole (D)

Anesthesia and Intensive Care Operative Unit, S. Martino Hospital, Belluno, Italy.

Daniele Guerino Biasucci (DG)

Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy.

Paolo Persona (P)

UOC Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy.

Tiziana Bove (T)

University-Hospital of Friuli Centrale, ASU FC, Udine, Italy.
Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, Unit of Anesthesia and Intensive Care, University of Pavia, Pavia, Italy.

Lorenzo Ball (L)

Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
Anesthesia and Critical Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.

Davide Chiumello (D)

Department of Anesthesia and Intensive Care, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy.

Francesco Forfori (F)

Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.

Edoardo de Robertis (E)

Department of Medicine and Surgery, University of Perugia, Perugia, Italy.

Paolo Pelosi (P)

Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
Anesthesia and Critical Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.

Paolo Navalesi (P)

UOC Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy.

Antonino Giarratano (A)

Department of Surgical, Oncological and Oral Science (Di.Chir.On.S), University of Palermo, Palermo, Italy.
Department of Anesthesia Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy.

Flavia Petrini (F)

Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI), Rome, Italy.

Classifications MeSH