The following is a summary of “Lung ultrasound to predict gas-exchange response to prone positioning in COVID-19 patients: A prospective study in pilot and confirmation cohorts” published in the October 2022 issue of Critical Care by Heldeweg, et al.

The purpose of this study is to determine whether or not lung ultrasonography performed prior to prone positioning can accurately predict the ensuing gas-exchange response. Patients with COVID-19 who are in critical condition will be the focus of this prospective observational study. Before and after the position switch, gas-exchange parameters were recorded, and lung ultrasonography was done.

Together, the pilot and confirmation cohorts comprise 36 and 43 patients, respectively. Pre-turn lung ultrasonography score index (LUSI) and post-turn PaO2/FiO2 change were moderately correlated in the pilot sample. The results were replicated and expanded upon in the validation cohort. The highest connection with follow-up time points following prone positioning was found for the anterior LUSI at 1, 6, and 24 hours in the confirmation cohort. 

In a multivariate analysis, a decrease in anterior aeration (odds ratio 0.035; 95% CI 0.003-0.319 for anterior LUSI >50%) and an increase in pre-turn PaCO2 (odds ratio 0.479; 95% CI 0.235-0.979) were both correlated with a decrease in the PaO2/FiO2 increase of 20 mmHg. In addition to other clinical criteria, the anterior LUSI may be used to help determine the best respiratory strategy for a patient with COVID-19 and whether or not to have them lie prone.