Focussed Assessment with Sonography in acute Lassa Fever (FASLa): Development of a point-of-care protocol and description of common ultrasound findings
Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved..
BACKGROUND: Managing Lassa fever (LF) patients is challenging because of the complexity of this life-threatening infectious disease, the necessary isolation measures, and the limited resources in countries where it is endemic. Point-of-care ultrasonography (POCUS) is a promising low-cost imaging technique that may help in guiding the management of patients.
METHODS: We conducted this observational study at the Irrua Specialist Teaching Hospital in Nigeria. We developed a POCUS protocol, trained local physicians who applied the protocol to LF patients and recorded and interpreted the clips. These were then independently re-evaluated by an external expert, and associations with clinical, laboratory and virological data were analyzed.
FINDINGS: We developed the POCUS protocol based on existing literature and expert opinion and trained two clinicians, who then used POCUS to examine 46 patients. We observed at least one pathological finding in 29 (63%) patients. Ascites was found in 14 (30%), pericardial effusion in 10 (22%), pleural effusion in 5 (11%), and polyserositis in 7 (15%) patients, respectively. Eight patients (17%) showed hyperechoic kidneys. Seven patients succumbed to the disease while 39 patients survived, resulting in a fatality rate of 15%. Pleural effusions and hyper-echoic kidneys were associated with increased mortality.
INTERPRETATION: In acute LF, a newly established POCUS protocol readily identified a high prevalence of clinically relevant pathological findings. The assessment by POCUS required minimal resources and training; the detected pathologies such as pleural effusions and kidney injury may help to guide the clinical management of the most at-risk LF patients.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:87 |
|---|---|
| Enthalten in: |
The Journal of infection - 87(2023), 1 vom: 31. Juli, Seite 27-33 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Erameh, Cyril O [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Hemorrhagic viruses |
|---|
| Anmerkungen: |
Date Completed 20.06.2023 Date Revised 21.02.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jinf.2023.04.008 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM355797402 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM355797402 | ||
| 003 | DE-627 | ||
| 005 | 20240222091248.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jinf.2023.04.008 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1301.xml |
| 035 | |a (DE-627)NLM355797402 | ||
| 035 | |a (NLM)37075910 | ||
| 035 | |a (PII)S0163-4453(23)00208-6 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Erameh, Cyril O |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Focussed Assessment with Sonography in acute Lassa Fever (FASLa): Development of a point-of-care protocol and description of common ultrasound findings |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 20.06.2023 | ||
| 500 | |a Date Revised 21.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a BACKGROUND: Managing Lassa fever (LF) patients is challenging because of the complexity of this life-threatening infectious disease, the necessary isolation measures, and the limited resources in countries where it is endemic. Point-of-care ultrasonography (POCUS) is a promising low-cost imaging technique that may help in guiding the management of patients | ||
| 520 | |a METHODS: We conducted this observational study at the Irrua Specialist Teaching Hospital in Nigeria. We developed a POCUS protocol, trained local physicians who applied the protocol to LF patients and recorded and interpreted the clips. These were then independently re-evaluated by an external expert, and associations with clinical, laboratory and virological data were analyzed | ||
| 520 | |a FINDINGS: We developed the POCUS protocol based on existing literature and expert opinion and trained two clinicians, who then used POCUS to examine 46 patients. We observed at least one pathological finding in 29 (63%) patients. Ascites was found in 14 (30%), pericardial effusion in 10 (22%), pleural effusion in 5 (11%), and polyserositis in 7 (15%) patients, respectively. Eight patients (17%) showed hyperechoic kidneys. Seven patients succumbed to the disease while 39 patients survived, resulting in a fatality rate of 15%. Pleural effusions and hyper-echoic kidneys were associated with increased mortality | ||
| 520 | |a INTERPRETATION: In acute LF, a newly established POCUS protocol readily identified a high prevalence of clinically relevant pathological findings. The assessment by POCUS required minimal resources and training; the detected pathologies such as pleural effusions and kidney injury may help to guide the clinical management of the most at-risk LF patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Hemorrhagic viruses | |
| 650 | 4 | |a Lassa fever | |
| 650 | 4 | |a POCUS | |
| 650 | 4 | |a Sonography | |
| 650 | 4 | |a Ultrasound | |
| 700 | 1 | |a Koch, Till |e verfasserin |4 aut | |
| 700 | 1 | |a Edeawe, Osahogie Isaac |e verfasserin |4 aut | |
| 700 | 1 | |a Oestereich, Lisa |e verfasserin |4 aut | |
| 700 | 1 | |a Omansen, Till |e verfasserin |4 aut | |
| 700 | 1 | |a Jochum, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Adomeh, Donatus I |e verfasserin |4 aut | |
| 700 | 1 | |a Ikponmwonsa, Odia |e verfasserin |4 aut | |
| 700 | 1 | |a Aire, Chris |e verfasserin |4 aut | |
| 700 | 1 | |a Pahlmann, Meike |e verfasserin |4 aut | |
| 700 | 1 | |a Asogun, Danny A |e verfasserin |4 aut | |
| 700 | 1 | |a Ogbaini-Emovon, Ephraim |e verfasserin |4 aut | |
| 700 | 1 | |a Okogbenin, Sylvanus A |e verfasserin |4 aut | |
| 700 | 1 | |a Günther, Stephan |e verfasserin |4 aut | |
| 700 | 1 | |a Ramharter, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Akideno, Peter E |e verfasserin |4 aut | |
| 700 | 1 | |a Kreuels, Benno |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of infection |d 1982 |g 87(2023), 1 vom: 31. Juli, Seite 27-33 |w (DE-627)NLM012791822 |x 1532-2742 |7 nnns |
| 773 | 1 | 8 | |g volume:87 |g year:2023 |g number:1 |g day:31 |g month:07 |g pages:27-33 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jinf.2023.04.008 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 87 |j 2023 |e 1 |b 31 |c 07 |h 27-33 | ||