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Case Reports
. 2025 Jan 16;25(1):36.
doi: 10.1186/s12887-024-05308-7.

Modified lung ultrasound score for improved monitoring of pARDS on ECMO, a case report

E Küng  1 , L Aichhorn  2 , M Di Nardo  3 , F Cardona  1 , A Berger  1 , R I Milos  4 , M Watzenböck  4 , J B Brandt  1
Affiliations
Case Reports

Modified lung ultrasound score for improved monitoring of pARDS on ECMO, a case report

E Küng et al. BMC Pediatr. .

Abstract

Background: Lung ultrasound scoring is a validated tool for assessing lung pathology. However, existing scoring systems typically overlook the size of consolidations, limiting their accuracy in certain clinical scenarios.

Case presentation: We describe the first application of adding the maximum consolidation depth in centimeters (cm) to the conventional score. This modification (LUS+) was used in an eight-month-old patient with severe respiratory failure undergoing extracorporeal life support (ECLS). Spearman's correlation analysis revealed a similar correlation in LUS+ compared to conventional lung ultrasound score. Importantly, LUS + showed improvement following cessation of lung rest on day 5, preceding the changes observed in conventional lung ultrasound scores and tidal volume measurements on day 9.

Conclusions: The integration of consolidation depth, quantified in centimeters, represents a valuable refinement of the conventional lung ultrasound score, enhancing its utility in monitoring pediatric acute respiratory distress patients undergoing ECLS.

Keywords: Case Report; Child; Extracorporeal Life Support; Extracorporeal Membrane Oxygenation; Infant; Lung; Lung Ultrasound Score; Pediatric Acute Respiratory Distress Syndrome; Pediatric Critical Care; Prospective Studies.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: As this is an observational case report and no therapeutic interventions were undertaken, ethical approval was waived following the informed consent. Informed consent for participation and publication was obtained from the legal guardians. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Examples of modified lung ultrasound score (LUS+). Ultrasound images with different sized consolidations. While both images would be scored as a 3 by the lung ultrasound score published by Via et al. [2] and adapted by Brat et al. [3] we propose a scoring method of the same lung ultrasound scoring plus the depth of the consolidation rounded to whole numbers in cm (LUS+). This results in a score of 5 (3 + 2) in image A and a score of 8 (3 + 5) in image B
Fig. 2
Fig. 2
Timeline of the patient. This timeline of the patient shows modified lung ultrasound score (LUS+), conventional lung ultrasound score (LUS), Brixia Score, Percentage of Lung Opacity, RALE Score, SpO2 and tidal volume during extracorporeal life support (grey) and lung rest (dark grey)
See this image and copyright information in PMC

References

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