Accuracy and Applications of Lung Ultrasound to Diagnose Ventilator-Associated Pneumonia: A Systematic Review

Journal of Intensive Care Medicine
Leonardo Jönck StaubRosemeri Maurici

Abstract

Lung ultrasound (LUS) is an accurate tool to diagnose community-acquired pneumonia. However, it is not yet an established tool to diagnose ventilator-associated pneumonia (VAP). To assess the evidence about LUS in the diagnosis of VAP, we conducted a systematic review of the literature. We searched PubMed, Embase, Scopus, Web of Science, and LILACS. Two researchers independently selected the studies that met the inclusion criteria. Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of the studies. In a qualitative synthesis, 3 questions guided the review: Q1. What are the sonographic signs of VAP? Q2. How can LUS be combined with others tests or signs of VAP? Q3. What is the role of LUS in VAP screening? Three studies (n = 377 patients) with different designs were included. In terms of Q1, the 3 studies assessed the accuracy of sonographic consolidations. In patients suspected for VAP, lobar or hemilobar consolidation alone was not sufficient to diagnose VAP but seems useful to exclude it. The most useful signs were small subpleural consolidations (sensitivity: 81%; specificity: 41%) and dynamic air bronchograms (sensitivity: 44%; specificity: 81%). Two studies were assessed for Q2,...Continue Reading

References

Feb 9, 2005·American Journal of Respiratory and Critical Care Medicine·UNKNOWN American Thoracic Society, UNKNOWN Infectious Diseases Society of America
Jan 3, 2006·The European Respiratory Journal·C M LunaUNKNOWN Grupo Argentino de Estudio de la Neumonía Asociada al Respirador group
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Mar 25, 2008·Journal of Critical Care·François LauzierUNKNOWN Canadian Critical Care Trials Group
Jul 23, 2009·Annals of Internal Medicine·David MoherUNKNOWN PRISMA Group
Jul 28, 2009·Critical Care Medicine·Bélaïd BouhemadJean-Jacques Rouby
Aug 3, 2011·Intensive Care Medicine·Nektaria XirouchakiDimitrios Georgopoulos
Oct 19, 2011·Annals of Internal Medicine·Penny F WhitingUNKNOWN QUADAS-2 Group
Oct 30, 2014·The Cochrane Database of Systematic Reviews·Danilo Cortozi BertonPaulo José Zimermann Teixeira
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Jul 16, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Andre C KalilJan L Brozek

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Citations

Aug 17, 2019·Intensive Care Medicine·P H MayoM Zanobetti
Dec 11, 2019·Journal of Intensive Care Medicine·Leonardo Jönck StaubRosemeri Maurici
Aug 3, 2020·Current Opinion in Critical Care·Despoina KoulentiParaskevi C Fragkou
Mar 23, 2021·Frontiers in Big Data·Conor McDermottCarlos Rossa
Apr 2, 2021·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Ram E Rajagopalan
Jan 19, 2022·Seminars in Respiratory and Critical Care Medicine·Cherie Renaud, Marin H Kollef

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Methods Mentioned

BETA
bronchoalveolar lavage

Software Mentioned

Web
EAgram
Embase
Quality Assessment of Diagnostic Accuracy Studies ( QUADAS - 2 )
Scopus
VPLUS
EAquant

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