Modified lung ultrasound score for improved monitoring of pARDS on ECMO, a case report

Abstract

Background: Lung ultrasound scoring is a validated tool for assessing lung pathology. However, existing scoring systems typically overlook the size of consolidations, limiting their accuracy in certain clinical scenarios. Case presentation: We describe the first application of adding the maximum consolidation depth in centimeters (cm) to the conventional score. This modification (LUS+) was used in an eight-month-old patient with severe respiratory failure undergoing extracorporeal life support (ECLS). Spearman’s correlation analysis revealed a similar correlation in LUS+ compared to conventional lung ultrasound score. Importantly, LUS + showed improvement following cessation of lung rest on day 5, preceding the changes observed in conventional lung ultrasound scores and tidal volume measurements on day 9. Conclusions: The integration of consolidation depth, quantified in centimeters, represents a valuable refinement of the conventional lung ultrasound score, enhancing its utility in monitoring pediatric acute respiratory distress patients undergoing ECLS.