Lung ultrasonography for the diagnosis of 11 patients with acute respiratory distress syndrome due to bird flu H7N9 infection.
BACKGROUND
A novel reassortant avian-origin influenza A (H7N9) virus was found to infect three Chinese residents, the first H7N9 infection in humans in Asia. Chest computed tomography (CT) for acute respiratory distress syndrome (ARDS) diagnosis is not only expensive but also exposes patients to radiation and might cause patients to be at risk of infection during transportation; in addition, chest radiography cannot be used to monitor the lung repeatedly in real time. Therefore, the routine use of bedside lung ultrasonography for critically ill patients with ARDS is especially valuable.


OBJECTIVE
The aim of this study was to evaluate the application of ultrasound for lung examination in patients with ARDS.


METHODS
Eleven patients infected with H7N9 avian influenza who developed ARDS were diagnosed by lung ultrasonography.


RESULTS
Six patients who had severe ARDS showed a diffuse comet tail sign or a consolidation score ≥ 7 and a lung ultrasound score ≥ 20 points. A diffuse comet tail sign or a consolidation score ≤ 6 and a lung ultrasound score < 25 were observed in four patients. One patient showed a diffuse comet tail sign or consolidation area in four lung areas, with an ultrasound score of 14. Among all 11 patients studied, 6 patients had thoracic puncture and drainage of pleural effusion and 2 patients had pneumothorax puncture drainage.


CONCLUSIONS
Lung ultrasound could be useful for monitoring ARDS caused by the influenza virus A H7N9 strain in clinical applications.
Intensive Care Unit of the Department of Anesthesiology, The First Hospital Affiliated to Suzhou University, Suzhou, 215006, Jiangsu, China. 1991006579@qq.com.
Yu-Kun
YK
Zhang
Intensive Care Unit of the Department of Anesthesiology, The First Hospital Affiliated to Suzhou University, Suzhou, 215006, Jiangsu, China. kentleesz@suda.edu.cn.
Jian
J
Li
Intensive Care Unit of the Department of Anesthesiology, The First Hospital Affiliated to Suzhou University, Suzhou, 215006, Jiangsu, China. szyangjp@gmail.com.
Jian-Ping
JP
Yang
Intensive Care Unit of the Department of Anesthesiology, The First Hospital Affiliated to Suzhou University, Suzhou, 215006, Jiangsu, China. xzhanying@yahoo.com.cn.
Ying
Y
Zhan
Intensive Care Unit of the Department of Anesthesiology, The First Hospital Affiliated to Suzhou University, Suzhou, 215006, Jiangsu, China. szcj69@sina.com.
Jun
J
Chen
D000328:Adult; D000368:Aged; D000818:Animals; D002681:China; D016638:Critical Illness; D005260:Female; D006801:Humans; D064766:Influenza A Virus, H7N9 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis* / Q000473:pathology / Q000821:virology*; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D012128:Respiratory Distress Syndrome / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography / Q000379:methods*