Additional contributors: Dr. K. Lessnau (NYC) and Dr. D. Buonsenso, (Rome)
Front line
physicians in Italy and Spain Rome
The use of
CT lung imaging for COVID-19 has been the diagnostic standard for the last few
months of the current epidemic. CT has
the disadvantage of logistics (staff, patients, transport) and radiation
exposure. Respiratory distress creates motion artifacts on images that may
simulate pulmonary inflammation. Since the disease mutates often, frequent
imaging may be required. Viral pneumonia is not diagnostically distinguishable
from other viral inflammations in the lung so the argument for a screening
modality is useful to separate the critically ill from those needing outpatient
treatment. Dr. Klaus Lessnau, author of
CHEST ULTRASOUND (Springer 2003), employs both CT and ultrasound imaging in
clinical practice.
Dr. Bard reviews international healthcare updates including recent
reports by Dr. Buonsenso about the Covid crisis. As a community of assumed
carriers and not clinically affected, Dr. Buonsenso is also actively
investigating the pediatric population with the expanded use of lung
ultrasound. “The global pandemic demands
effective answers toward a cure as well as protection of healthcare workers on
duty. I have the highest regard for the European approach to problem solving
both clinically and technologically… applying Dr. Buonsenso’s concept makes
perfect sense and carries great value in our war against Covid-19.”
According to
Dr. Bard, Lung ultrasound has been used in emergency rooms since it was
introduced to the Mt Sinai Medical School in 2014 and is now used nationwide to
diagnose pneumonia (viral or bacterial) in children which spares them
unnecessary x-rays since it is so accurate. “It is like an electronic
stethoscope since lung disease and heart failure producing pulmonary fluid
buildup are diagnosed or confirmed with portable ultrasound units at the
bedside. This is considered the best imaging tool to diagnose a collapsed lung
in seconds which has proven lifesaving as a time saver for on the spot
detection.”
In a recent
telehealth conference, Dr. Bard explains how ultrasound probes study the lungs between
the ribs to read the lung surface where most Covid pathology is situated. The virus has known cardiac toxicity so the
same sonogram unit may image the heart for fluid buildup and weakened
contraction. This may differentiate heart failure from pulmonary infection in
some cases which may have similar clinical presentations.
Ultrasound
probes study the lungs via the ribs showing the lung surface (where most Covid
pathology is situated) and adjacent lung tissue. The abdominal scan with the
curved transducer has a larger field of view and affords a rapid assessment of
B lines (Fig 1), pleural effusion and frank pneumonia (Fig 2). Portable units have the advantage of
containment within a sterile sleeve preventing accidental viral spread to
imaging equipment necessitating full decontamination procedures.
Some infected European physicians are
monitoring their disease at home via the B line count-few B lines suggest low
grade inflamed lung tissue-increasing B line count calls for more aggressive
treatment. All clinical imaging was correlated with the patient’s oxygen
saturation and clinical setting. The
virus has potential cardiac toxicity so the same sonogram unit may image the
heart for fluid buildup and weakened contraction. This may differentiate heart
failure from pulmonary infection in some cases which may have similar clinical
presentations.
Dr. Bard
currently runs a private imaging center in NYC specializing in advanced 3-D
sonography to detect cancers and other health disorders. He lectures in medical conferences worldwide, runs a volunteer
cancer awareness program for first responders and is also a publisher of countless
educational books and articles about cancer imaging and other health/wellness
related materials. Additional info. on this topic may be found in Dr. Bard’s
newsletter (prevention101.org). For
interviews, call our media director: Grace Dellavalle @ 631-920-5757 or email:
nycralliance@gmail.com
# # #
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