Ten Questions on Using Lung Ultrasonography to Diagnose and Manage Pneumonia in the Hospital-at-Home Model: Part I—Techniques and Patterns

The hospital-at-home (HaH) model delivers hospital-level acute care, including diagnostics, monitoring, and treatments, in a patient’s home. It is particularly effective for managing conditions such as pneumonia. Point-of-care ultrasonography (PoCUS) is a key diagnostic tool in the HaH model, and it...

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Main Authors: Nin-Chieh Hsu, Yu-Feng Lin, Hung-Bin Tsai, Tung-Yun Huang, Chia-Hao Hsu
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/24/2799
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author Nin-Chieh Hsu
Yu-Feng Lin
Hung-Bin Tsai
Tung-Yun Huang
Chia-Hao Hsu
author_facet Nin-Chieh Hsu
Yu-Feng Lin
Hung-Bin Tsai
Tung-Yun Huang
Chia-Hao Hsu
author_sort Nin-Chieh Hsu
collection DOAJ
description The hospital-at-home (HaH) model delivers hospital-level acute care, including diagnostics, monitoring, and treatments, in a patient’s home. It is particularly effective for managing conditions such as pneumonia. Point-of-care ultrasonography (PoCUS) is a key diagnostic tool in the HaH model, and it often serves as a substitute for imaging-based diagnosis in the HaH setting. Both standard and handheld ultrasound equipment are suitable for lung ultrasound (LUS) evaluation. Curvelinear and linear probes are typically used. Patient positioning depends on their clinical condition and specific diagnostic protocols. To enhance sensitivity, we recommend using at least 10-point protocols supported by studies for pneumonia. Five essential LUS patterns should be identified, including A-line, multiple B-lines (alveolar-interstitial syndrome), confluent B-lines, subpleural consolidation, and consolidation with air bronchogram. Pleural effusion is common, and its internal echogenicity can indicate severity and the need for invasive procedures. The current evidence on various etiologies and types of pneumonia is limited, but LUS demonstrates good sensitivity in detecting abnormal sonographic patterns in atypical pneumonia, tuberculosis, and ventilator-associated pneumonia. Further LUS studies in the HaH setting are required to validate and generalize the findings.
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spelling doaj-art-993d7a5c83f24c8d864ac4cbbbb827222024-12-27T14:20:47ZengMDPI AGDiagnostics2075-44182024-12-011424279910.3390/diagnostics14242799Ten Questions on Using Lung Ultrasonography to Diagnose and Manage Pneumonia in the Hospital-at-Home Model: Part I—Techniques and PatternsNin-Chieh Hsu0Yu-Feng Lin1Hung-Bin Tsai2Tung-Yun Huang3Chia-Hao Hsu4Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100225, TaiwanDepartment of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100225, TaiwanDivision of Hospital Medicine, Department of Internal Medicine, Taipei City Hospital Zhongxing Branch, Taipei 103212, TaiwanDepartment of Otolaryngology, National Taiwan University Hospital, Taipei 100225, TaiwanDepartment of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung 807378, TaiwanThe hospital-at-home (HaH) model delivers hospital-level acute care, including diagnostics, monitoring, and treatments, in a patient’s home. It is particularly effective for managing conditions such as pneumonia. Point-of-care ultrasonography (PoCUS) is a key diagnostic tool in the HaH model, and it often serves as a substitute for imaging-based diagnosis in the HaH setting. Both standard and handheld ultrasound equipment are suitable for lung ultrasound (LUS) evaluation. Curvelinear and linear probes are typically used. Patient positioning depends on their clinical condition and specific diagnostic protocols. To enhance sensitivity, we recommend using at least 10-point protocols supported by studies for pneumonia. Five essential LUS patterns should be identified, including A-line, multiple B-lines (alveolar-interstitial syndrome), confluent B-lines, subpleural consolidation, and consolidation with air bronchogram. Pleural effusion is common, and its internal echogenicity can indicate severity and the need for invasive procedures. The current evidence on various etiologies and types of pneumonia is limited, but LUS demonstrates good sensitivity in detecting abnormal sonographic patterns in atypical pneumonia, tuberculosis, and ventilator-associated pneumonia. Further LUS studies in the HaH setting are required to validate and generalize the findings.https://www.mdpi.com/2075-4418/14/24/2799pneumoniapoint-of-careultrasonographyhospital-at-homediagnosistreatment
spellingShingle Nin-Chieh Hsu
Yu-Feng Lin
Hung-Bin Tsai
Tung-Yun Huang
Chia-Hao Hsu
Ten Questions on Using Lung Ultrasonography to Diagnose and Manage Pneumonia in the Hospital-at-Home Model: Part I—Techniques and Patterns
Diagnostics
pneumonia
point-of-care
ultrasonography
hospital-at-home
diagnosis
treatment
title Ten Questions on Using Lung Ultrasonography to Diagnose and Manage Pneumonia in the Hospital-at-Home Model: Part I—Techniques and Patterns
title_full Ten Questions on Using Lung Ultrasonography to Diagnose and Manage Pneumonia in the Hospital-at-Home Model: Part I—Techniques and Patterns
title_fullStr Ten Questions on Using Lung Ultrasonography to Diagnose and Manage Pneumonia in the Hospital-at-Home Model: Part I—Techniques and Patterns
title_full_unstemmed Ten Questions on Using Lung Ultrasonography to Diagnose and Manage Pneumonia in the Hospital-at-Home Model: Part I—Techniques and Patterns
title_short Ten Questions on Using Lung Ultrasonography to Diagnose and Manage Pneumonia in the Hospital-at-Home Model: Part I—Techniques and Patterns
title_sort ten questions on using lung ultrasonography to diagnose and manage pneumonia in the hospital at home model part i techniques and patterns
topic pneumonia
point-of-care
ultrasonography
hospital-at-home
diagnosis
treatment
url https://www.mdpi.com/2075-4418/14/24/2799
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