EUROPEAN IMAGING COLLEAGUES CONFIRM LUNG ULTRASOUND BENEFITS FOR COVID-19 TRIAGE

April 2, 2020 - Dr. Robert L. Bard, NYC imaging specialist collaborates with an international group of medical leaders including Dr. Danilo Buonsenso (Rome, Italy) who recently published reports about "ultrasound equipment as an effective replacement of the stethoscope.”  Dr. Buonsenso's review presents the valid uses and benefits of Lung Ultrasound in identifying respiratory disorders that may be associated with Covid-19.

Currently, front line physicians in Italy and Spain are reportedly triaging with portable ultrasound units that reduce logistical problems of a chaotic environment and healthcare worker exposure. Since imaging with CT or ultrasound is not diagnostic, determining who needs hospitalization is essential in a pandemic overwhelming medical providers.  Dr. Buonsenso, at the viral epicenter in Rome, uses sonograms to decide who requires a CT scan.

Sonogram taken under rib cage shows liver (grey) with curved diaphragm-
lung border (white) Arrows point to vertical B lines (white) demonstrating
diseased lung tissue.  The more B lines the worse the disease. Healing is
measured by reduction in the number of B lines

The use of CT lung imaging for COVID-19 has been recognized as the diagnostic standard during our current epidemic. Meanwhile, experts find CT to have  disadvantages like radiation exposure. Respiratory distress creates motion artifacts on images that may simulate pulmonary inflammation. Also, 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.  This review was stated by Dr. Klaus Lessnau, author of "Atlas of Chest Sonography" (Springer 2003), employs both CT and ultrasound imaging in clinical practice.

Dr. Bard reviews international healthcare and technology updates as part of his continued research in the radiological society. This includes Dr. Buonsenso's national reports about the Covid crisis and the expanded use of lung ultrasound as part of his investigation of children as clinically unaffected carriers.  “The global pandemic demands effective answers toward a cure as well as protection of healthcare workers on duty", says Dr. Bard. "I have the highest regard for the European approach to problem solving both clinically and technologically… applying Dr. Buonsenso’s concept makes perfect sense to me and carries great value in our war against Covid-19.”

Ultrasound probes study the lungs between the ribs to
read the lung surface where most Covid pathology is situated

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.  (Image 1) Portable units have the advantage of containment within a sterile sleeve, preventing accidental viral spread to imaging equipment necessitating full decontamination procedures.  All clinical imaging was correlated with the patient’s oxygen saturation and clinical setting.     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.

About Dr. Bard

Dr. Robert Bard currently runs a private imaging center in NYC specializing in advanced 3-D sonography to detect cancer tumors and other health disorders.  He lectures in medical conferences worldwide, runs a 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.

Dr. Bard maintains an active role in supporting the medical community by contributing relevant articles to major health magazines, medical journals and news organizations pertaining to current health concerns. His recent projects include advocating and inserting TELEMEDCINE in the medical community as a safe alternative for patients.  Other projects include an upcoming collaborative textbook series on Covid-19 with a list of top experts in the field.  Dr. Bard is also the president of the AngioFoundation (501c3), as philanthropic organization dedicated to funding and supporting public education about current treatment protocols worldwide. 

About Dr. Buonsenso
Actively practicing as a Pediatrician from Gemelli University Hospital in Italy, Dr. Danilo Buonsenso received his medical degree from the Catholic University of the Sacred Heart in Rome in 2010. He was a resident in The School of Pediatrics in the Catholic University of the Sacred Heart till 2016. From January 2016, he was a Head Director of a social and health developing program in the community of Bureh Town, Sierra Leone which aimed to bring medical and social support to fragile populations. At present, he is a Pediatrician at the Department of Woman and Child Health and Publich Health at the Gemelli University Hospital, Rome, Italy.

Dr. Buonsenso's basic personal skills are in Infectious diseases, Pediatric ER and Pediatric Ultrasonography. He has published almost 50 papers in various journals of Pediatrics and has received various grants such as a Grant as a young collaborator by The Italian Minister of Health for the Bando Ricerca Finalizzata 2018, on the role of NGF on brain function recovery after severe brain injury. (Source)

About Dr. Klaus Lessnau
Dr. Klaus Lessnau specializes in Pulmonology, Sleep Medicine, Insomnia Testing, Sleep Apnea Testing, Pulmonary Function Testing.  He is a highly regarded Pulmonologist and a Sleep Medicine specialist with the 14 Street Medical Arts team in NYC. Dr. Lessnau is board certified in Pulmonology, Bronchology, Sleep Medicine Disorders and is a Critical Care doctor with over 30 years of experience. He is also serving as a Director of Critical Care Medicine at Lennox Hill Hospital.

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References

1) Is there a role for lung ultrasound during the COVID‐19 pandemic?  - Danilo Buonsenso https://onlinelibrary.wiley.com/doi/abs/10.1002/jum.15284

2) The Lancet: COVID-19 outbreak: less stethoscope, more ultrasound" https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30120-X/fulltext

Danilo Buonsenso | Davide Pata | Antonio Chiaretti - Published:March 20, 2020

3) Dr. Klaus Lessnau, author of "Atlas of Chest Sonography" (Springer 2003) https://link.springer.com/book/10.1007%2F978-3-662-05278-5

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