Feasibility of using a handheld ultrasound device to detect and characterize shunt and deep vein thrombosis in patients with COVID-19: an observational study

The Ultrasound Journal

Table 1 Correlation of respiratory support with findings on imaging and outcomes

Subject	1	2	3	4
Respiratory support	High-flow nasal canula		Mechanical ventilation VC (AC) via endotracheal tube
FiO₂	0.6	0.7	1.0	1.0
Flow (l/min)	60	60	–	–
PEEP (cmH₂O)	–	–	10	10
Tidal volume set/achieved (ml)	–	–	370/374	330/265
Peak airway pressure (cmH₂O)	–	–	34	32
Dynamic compliance (ml/cmH2O)	–	–	15.6	12
SpO₂	88%	89%	98%	97%
PaO₂/FiO₂	111	61	64	82
Lung ultrasound score	22	20	17	20
Lung ultrasound findings	Interstitial syndrome with pleural line thickening and irregularities, in all 12 zones, with light beams, and bilateral patchy areas with small peripheral consolidations
Lung ultrasound findings			Left lobar consolidation, and moderate left pleural effusion	Bibasal atelectasis
DVT ultrasound	Negative	Negative	Negative	Negative
Echocardiography	Normal	Normal	Dilated RV with impaired function	Normal
Saline microbubble contrast study	Negative	Grade 2 interatrial shunt	Grade 4 interatrial shunt	Grade 3 intrapulmonary shunt
Day of imaging (after admission)	Day 9	Day 8	Day 14	Day 14
COVID-19 phenotype			H (high elastance)	H (high elastance)
Outcome	Discharged home Day 17	Intubated Day 10, discharged home Day 39	Death Day 17	Death Day 16

Shunt grading: grade 1: < 5 bubbles; grade 2: 5 to 25 bubbles; grade 3: > 25 bubbles; and grade 4: opacification of chamber [10]. DVT deep vein thrombosis, PEEP positive end expiratory pressure, RV right ventricle, VC (AC) volume control (assist control). Phenotypes of COVID-19 have been described: L (low elastance) and H (high elastance)