TY - JOUR T1 - Lung ultrasound assessment of focal and non-focal lung morphology in patients with ARDS – a post-hoc analysis JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2021.PA2417 VL - 58 IS - suppl 65 SP - PA2417 AU - Marry Smit AU - Charalampos Pierrakos AU - Luigi Pisani AU - Frederique Paulus AU - Marcus Schultz AU - Jean-Michel Constantin AU - Davide Chiumello AU - Francesco Mojoli AU - Silvia Mongodi AU - Lieuwe Bos Y1 - 2021/09/05 UR - http://erj.ersjournals.com/content/58/suppl_65/PA2417.abstract N2 - Background: The identification of phenotypes based on lung morphology can be helpful to better target mechanical ventilation of individual patients with ARDS.Aims and objectives: We aimed to develop a lung ultrasound (LUS) method for classification of lung morphology in critically ill ARDS patients under mechanical ventilation. We hypothesized that LUS can reliably assess lung morphology compared to gold standard chest CT.Methods: This was a post-hoc analysis on two prospective studies that performed LUS and chest CT scanning at the same time. Expert panels from two participating centres separately developed two LUS methods for classifying lung morphology based on LUS aeration scores from a 12-region exam (the ‘Amsterdam’ method and ‘Lombardy’ method). Accuracy of these LUS methods was estimated in the cohort of the other centre using CT as the gold standard.Results: The ‘Amsterdam’ and ‘Lombardy’ cohorts consisted of 32 and 19 ARDS patients respectively. From these patients, 23 had ‘focal’ lung morphology while others had ‘non-focal’ lung morphology. The ‘Amsterdam’ method could classify ‘focal’ lung morphology with a sensitivity of 77% and a specificity of 100%, while the ‘Lombardy’ method had a sensitivity and specificity of 100% and 61%. In both methods, most patients could be classified solely based on anterior LUS regions.Conclusions: LUS-based methods can accurately classify lung morphology in invasively ventilated ARDS patients compared to gold standard chest CT. The anterior LUS regions showed to be the most discriminant between ‘focal’ and ‘non-focal’ lung morphology.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA2417.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -