Critical Role of Cardiopulmonary Point-of-Care Ultrasound in the Era of COVID-19

摘要

In the era of coronavirus disease 2019 (COVID-19), limited utilization of medical facilities is one of the big issues in clinical practice. However, patients with suspected COVID-19 pneumonia should be evaluated systemically not just for lung, but also for cardiac involvement.1)2) The usual approach to patients with acute respiratory symptoms is chest X-ray and computed tomography (CT) scans, in accordance with blood biomarker studies. In addition, to differentiate cardiac origin of dyspnea, echocardiography is widely used in combination with electrocardiography and blood biomarkers. However, in the COVID-19 pandemic, sanitization is crucial after chest X-ray, CT, or echocardiography examination in suspected COVID-19 infection. This requires much more human and economic resources and raises the needs for rapid, portable but reliable bedside equipment for cardiopulmonary evaluation. Point-of-care ultrasound (PCOUS) including echocardiography and lung ultrasound (LUS) fits this purpose for use in the emergency room, intensive care unit (ICU), and outside the hospital, especially in patients on a mechanical ventilator. LUS is superior to supine portable chest X-ray for rapid evaluation of pneumothorax, alveolar interstitial pattern, consolidation, and pleural effusion. In addition, it has the advantages of immediate bedside availability, repeatability, cost saving, and reduction in radiation exposure.