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. 2022 Oct;43(5):464-472.
doi: 10.1055/a-1634-4710. Epub 2021 Nov 3.

Level of Diffusion and Training of Lung Ultrasound during the COVID-19 Pandemic - A National Online Italian Survey (ITALUS) from the Lung Ultrasound Working Group of the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI)

Luigi Vetrugno  1   2 , Francesco Mojoli  3   4 , Enrico Boero  5 , Paola Berchialla  6 , Elena Giovanna Bignami  7 , Daniele Orso  8 , Andrea Cortegiani  9   10 , Francesco Forfori  11 , Francesco Corradi  11 , Gianmaria Cammarota  12 , Edoardo De Robertis  13 , Silvia Mongodi  14   15 , Davide Chiumello  16 , Daniele Poole  17 , Mariachiara Ippolito  9   10 , Daniele Guerino Biasucci  18 , Paolo Persona  19 , Tiziana Bove  8   2 , Lorenzo Ball  20 , Paolo Pelosi  20 , Paolo Navalesi  19 , Massimo Antonelli  18 , Antonio Corcione  21 , Antonino Giarratano  9   10 , Flavia Petrini  22
Affiliations

Level of Diffusion and Training of Lung Ultrasound during the COVID-19 Pandemic - A National Online Italian Survey (ITALUS) from the Lung Ultrasound Working Group of the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI)

Luigi Vetrugno et al. Ultraschall Med. 2022 Oct.

Abstract
in English, German

Purpose: The goal of this survey was to describe the use and diffusion of lung ultrasound (LUS), the level of training received before and during the COVID-19 pandemic, and the clinical impact LUS has had on COVID-19 cases in intensive care units (ICU) from February 2020 to May 2020.

Materials and methods: The Italian Lung Ultrasound Survey (ITALUS) was a nationwide online survey proposed to Italian anesthesiologists and intensive care physicians carried out after the first wave of the COVID-19 pandemic. It consisted of 27 questions, both quantitative and qualitative.

Results: 807 responded to the survey. The median previous LUS experience was 3 years (IQR 1.0-6.0). 473 (60.9 %) reported having attended at least one training course on LUS before the COVID-19 pandemic. 519 (73.9 %) reported knowing how to use the LUS score. 404 (52 %) reported being able to use LUS without any supervision. 479 (68.2 %) said that LUS influenced their clinical decision-making, mostly with respect to patient monitoring. During the pandemic, the median of patients daily evaluated with LUS increased 3-fold (p < 0.001), daily use of general LUS increased from 10.4 % to 28.9 % (p < 0.001), and the daily use of LUS score in particular increased from 1.6 % to 9.0 % (p < 0.001).

Conclusion: This survey showed that LUS was already extensively used during the first wave of the COVID-19 pandemic by anesthesiologists and intensive care physicians in Italy, and then its adoption increased further. Residency programs are already progressively implementing LUS teaching. However, 76.7 % of the sample did not undertake any LUS certification.

ZIEL: Das Ziel dieser Umfrage war es, den Einsatz und die Verbreitung von Lungenultraschall (LUS), den Ausbildungstand vor und während der COVID-19-Pandemie sowie die klinische Bedeutung des LUS auf COVID-19-Fälle auf Intensivstationen (ICU) von Februar 2020 bis Mai 2020 zu beschreiben.

Material und methoden: Die „Italian Lung Ultrasound Survey“ (ITALUS) war eine landesweite Online-Umfrage, die italienischen Anästhesisten und Intensivmedizinern nach der ersten Welle der COVID-19-Pandemie unterbreitet wurde. Sie bestand aus 27 quantitativen und qualitativen Fragen.

Ergebnisse: 807 Ärzte nahmen an der Umfrage teil. Die Vorerfahrung im LUS lag bei median 3 Jahren (IQR 1,0–6,0). 473 (60,9 %) gaben an, vor der COVID-19-Pandemie mindestens eine Schulung zu LUS besucht zu haben. 519 (73,9 %) gaben an, mit dem LUS-Score vertraut zu sein. 404 (52 %) gaben an, LUS ohne Aufsicht nutzen zu können. 479 (68,2 %) gaben an, dass LUS ihre klinische Entscheidungsfindung beeinflusst, vor allem in Bezug auf die Patientenüberwachung. Während der Pandemie stieg der Median der Patienten, die täglich mit LUS untersucht wurden, um das 3-Fache (p < 0,001), der tägliche Einsatz des allgemeinen LUS erhöhte sich von 10,4 % auf 28,9 % (p < 0,001), und insbesondere der tägliche Einsatz des LUS-Scores stieg von 1,6 % auf 9,0 % (p < 0,001).

Schlussfolgerung: Diese Umfrage zeigte, dass LUS bereits während der ersten Welle der COVID-19-Pandemie von Anästhesisten und Intensivmedizinern in Italien in großem Umfang eingesetzt wurde und dann weiter zugenommen hat. In der Facharztausbildung wird LUS bereits zunehmend eingeführt. Allerdings hatten in der Stichprobe 76,7 % keine LUS-Zertifizierung.

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Conflict of interest statement

Francesco Mojoli, fee for lectures (Hamilton Medical, GE Healthcare, SEDA Spa). Consultancy agreement between University of Pavia and Hamilton Medical.Silvia Mongodi, received fees for lectures by GE healthcare, outside the present work.

Figures

Fig. 1
Fig. 1
a Distribution of the respondents by geographic area. Legend: The blue gradation from 0 % to 15 % represents lung ultrasound utilization for each area. b Boxplot of the % of Italian regions.
Fig. 2
Fig. 2
Ultrasound probe with word cloud using the words provided in the survey answers.
See this image and copyright information in PMC

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