Arun Sett1,2,3,4,5, Gillian W C Foo6, Kelly R Kenna7, Rebecca J Sutton7,8, Elizabeth J Perkins7, Magdy Sourial8, Sheryle R Rogerson6,9,10, Brett J Manley7,6,9, Peter G Davis7,6,9, Prue M Pereira-Fantini7,6,11, David G Tingay7,6,11,12. 1. Neonatal Research, Murdoch Children's Research Institute, Parkville, VIC, Australia. arun.sett@mcri.edu.au. 2. Newborn Research Centre, The Royal Women's Hospital, Parkville, VIC, Australia. arun.sett@mcri.edu.au. 3. Joan Kirner Women's and Children's Hospital, Western Health, St Albans, VIC, Australia. arun.sett@mcri.edu.au. 4. Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC, Australia. arun.sett@mcri.edu.au. 5. Paediatric Infant Perinatal Emergency Retrieval, The Royal Children's Hospital, Parkville, VIC, Australia. arun.sett@mcri.edu.au. 6. Newborn Research Centre, The Royal Women's Hospital, Parkville, VIC, Australia. 7. Neonatal Research, Murdoch Children's Research Institute, Parkville, VIC, Australia. 8. Translational Research Unit, Murdoch Children's Research Institute, Parkville, VIC, Australia. 9. Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC, Australia. 10. Paediatric Infant Perinatal Emergency Retrieval, The Royal Children's Hospital, Parkville, VIC, Australia. 11. Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia. 12. Department of Neonatology, The Royal Children's Hospital, Parkville, VIC, Australia.
Abstract
BACKGROUND: Lung ultrasound (LUS) may not detect small, dynamic changes in lung volume. Mean greyscale measurement using computer-assisted image analysis (Q-LUSMGV) may improve the precision of these measurements. METHODS: Preterm lambs (n = 40) underwent LUS of the dependent or non-dependent lung during static pressure-volume curve mapping. Total and regional lung volumes were determined using the super-syringe technique and electrical impedance tomography. Q-LUSMGV and gold standard measurements of lung volume were compared in 520 images. RESULTS: Dependent Q-LUSMGV moderately correlated with total lung volume (rho = 0.60, 95% CI 0.51-0.67) and fairly with right whole (rho = 0.39, 0.27-0.49), central (rho = 0.38, 0.27-0.48), ventral (rho = 0.41, 0.31-0.51) and dorsal regional lung volumes (rho = 0.32, 0.21-0.43). Non-dependent Q-LUSMGV moderately correlated with total lung volume (rho = 0.57, 0.48-0.65) and fairly with right whole (rho = 0.43, 0.32-0.52), central (rho = 0.46, 0.35-0.55), ventral (rho = 0.36, 0.25-0.47) and dorsal lung volumes (rho = 0.36, 0.25-0.47). All correlation coefficients were statistically significant. Distinct inflation and deflation limbs, and sonographic pulmonary hysteresis occurred in 95% of lambs. The greatest changes in Q-LUSMGV occurred at the opening and closing pressures. CONCLUSION: Q-LUSMGV detected changes in total and regional lung volume and offers objective quantification of LUS images, and may improve bedside discrimination of real-time changes in lung volume. IMPACT: Lung ultrasound (LUS) offers continuous, radiation-free imaging that may play a role in assessing lung recruitment but may not detect small changes in lung volume. Mean greyscale image analysis using computer-assisted quantitative LUS (Q-LUSMGV) moderately correlated with changes in total and regional lung volume. Q-LUSMGV identified opening and closing pressure and pulmonary hysteresis in 95% of lambs. Computer-assisted image analysis may enhance LUS estimation of lung recruitment at the bedside. Future research should focus on improving precision prior to clinical translation.
BACKGROUND: Lung ultrasound (LUS) may not detect small, dynamic changes in lung volume. Mean greyscale measurement using computer-assisted image analysis (Q-LUSMGV) may improve the precision of these measurements. METHODS: Preterm lambs (n = 40) underwent LUS of the dependent or non-dependent lung during static pressure-volume curve mapping. Total and regional lung volumes were determined using the super-syringe technique and electrical impedance tomography. Q-LUSMGV and gold standard measurements of lung volume were compared in 520 images. RESULTS: Dependent Q-LUSMGV moderately correlated with total lung volume (rho = 0.60, 95% CI 0.51-0.67) and fairly with right whole (rho = 0.39, 0.27-0.49), central (rho = 0.38, 0.27-0.48), ventral (rho = 0.41, 0.31-0.51) and dorsal regional lung volumes (rho = 0.32, 0.21-0.43). Non-dependent Q-LUSMGV moderately correlated with total lung volume (rho = 0.57, 0.48-0.65) and fairly with right whole (rho = 0.43, 0.32-0.52), central (rho = 0.46, 0.35-0.55), ventral (rho = 0.36, 0.25-0.47) and dorsal lung volumes (rho = 0.36, 0.25-0.47). All correlation coefficients were statistically significant. Distinct inflation and deflation limbs, and sonographic pulmonary hysteresis occurred in 95% of lambs. The greatest changes in Q-LUSMGV occurred at the opening and closing pressures. CONCLUSION: Q-LUSMGV detected changes in total and regional lung volume and offers objective quantification of LUS images, and may improve bedside discrimination of real-time changes in lung volume. IMPACT: Lung ultrasound (LUS) offers continuous, radiation-free imaging that may play a role in assessing lung recruitment but may not detect small changes in lung volume. Mean greyscale image analysis using computer-assisted quantitative LUS (Q-LUSMGV) moderately correlated with changes in total and regional lung volume. Q-LUSMGV identified opening and closing pressure and pulmonary hysteresis in 95% of lambs. Computer-assisted image analysis may enhance LUS estimation of lung recruitment at the bedside. Future research should focus on improving precision prior to clinical translation.
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Authors: Inéz Frerichs; Marcelo B P Amato; Anton H van Kaam; David G Tingay; Zhanqi Zhao; Bartłomiej Grychtol; Marc Bodenstein; Hervé Gagnon; Stephan H Böhm; Eckhard Teschner; Ola Stenqvist; Tommaso Mauri; Vinicius Torsani; Luigi Camporota; Andreas Schibler; Gerhard K Wolf; Diederik Gommers; Steffen Leonhardt; Andy Adler Journal: Thorax Date: 2016-09-05 Impact factor: 9.139