{"id":152934,"date":"2020-03-16T16:27:37","date_gmt":"2020-03-16T23:27:37","guid":{"rendered":"https:\/\/clarius.com\/blog\/utilidad-clinica-y-tecnica-de-la-ecografia-pulmonar-en-casos-de-covid-19\/"},"modified":"2026-09-06T08:19:32","modified_gmt":"2026-09-06T15:19:32","slug":"utilidad-clinica-y-tecnica-de-la-ecografia-pulmonar-en-casos-de-covid-19","status":"publish","type":"post","link":"https:\/\/clarius.com\/es\/blog\/utilidad-clinica-y-tecnica-de-la-ecografia-pulmonar-en-casos-de-covid-19\/","title":{"rendered":"Utilidad cl\u00ednica y t\u00e9cnica de la ecograf\u00eda pulmonar en casos de COVID-19"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Daniel J. Kim, MD FRCPC<\/p>\n\n<table><tr><td width=\"40%\" style=\"padding:30px\"><figure class=\"wp-block-image size-large is-resized is-style-circle-mask\"><img decoding=\"async\" data-src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/03\/DanKim.jpeg\" alt=\"\" class=\"wp-image-9875 lazyload\" width=\"200\" height=\"200\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 200px; --smush-placeholder-aspect-ratio: 200\/200;\" \/><\/figure><\/td><td><i>El Dr. Kim es m\u00e9dico de urgencias en Vancouver. Para ayudar a los usuarios de Clarius a comprender c\u00f3mo pueden utilizar la ecograf\u00eda en el cribado y seguimiento de la COVID-19, pedimos al Dr. Kim que elaborara un art\u00edculo resumiendo las mejores pr\u00e1cticas actuales. Clarius compartir\u00e1 actualizaciones sobre el uso de la ecograf\u00eda para COVID-19 a medida que disponga de m\u00e1s informaci\u00f3n y recursos.  <\/i><\/td><\/tr><\/table>\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n<p class=\"wp-block-paragraph\">Desde el brote de un nuevo coronavirus en Wuhan en diciembre de 2019 y\nsu posterior evoluci\u00f3n a pandemia en marzo de 2020, ha crecido el inter\u00e9s\npor la utilidad de la ecograf\u00eda pulmonar en el estudio y tratamiento del COVID-19.<\/p>\n\n<p class=\"wp-block-paragraph\"><strong>Exploraci\u00f3n<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Dado que los hallazgos de imagen son inespec\u00edficos, en un paciente\ncl\u00ednicamente bien y con s\u00edntomas leves, la ecograf\u00eda pulmonar no tiene utilidad. Estos pacientes de\ndeben someterse a pruebas con hisopos nasofar\u00edngeos para RT-PCR seg\u00fan las directrices locales de salud p\u00fablica de\n. <\/p>\n\n<p class=\"wp-block-paragraph\">Se han notificado casos de pacientes con hallazgos t\u00edpicos de COVID-19 en la TC tor\u00e1cica\nque tuvieron resultados iniciales negativos de la RT-PCR. Los 5 de estos pacientes\ntuvieron finalmente resultados positivos de RT-PCR tras repetir las pruebas. La ecograf\u00eda pulmonar\npuede ser \u00fatil para los pacientes con una alta sospecha cl\u00ednica de\nCOVID-19 pero un cribado RT-PCR negativo si presentan hallazgos ecogr\u00e1ficos pulmonares\nt\u00edpicos de COVID-19.    &lt;1&gt;<\/p>\n\n<p class=\"wp-block-paragraph\"><strong>T\u00e9cnica<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">2 peque\u00f1os estudios que describen los hallazgos de la ecograf\u00eda pulmonar COVID-19 emplearon un enfoque\ncentrado en 12 \u00e1reas. &lt;2,3&gt; Cada pulm\u00f3n se dividi\u00f3 por la l\u00ednea axilar\nanterior y la l\u00ednea axilar posterior en 3 \u00e1reas: anterior, lateral y\nposterior. Cada una de estas \u00e1reas se dividi\u00f3 posteriormente en un campo\nsuperior e inferior, de modo que cada pulm\u00f3n se dividi\u00f3 en 6 \u00e1reas. Para maximizar la sensibilidad, debe visualizarse la mayor\nparte posible del campo pulmonar.  <\/p>\n\n<p class=\"wp-block-paragraph\">Es preferible utilizar una sonda lineal para identificar las anomal\u00edas pleurales y\nsubpleurales. Una sonda curvil\u00ednea o phased array es mejor para\ndemostrar las l\u00edneas B. La exploraci\u00f3n pulmonar debe realizarse perpendicularmente a\nel contorno de la l\u00ednea pleural.  <\/p>\n\n<p class=\"wp-block-paragraph\"><strong>Diagn\u00f3stico<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">2 peque\u00f1os estudios que incluyen 20 pacientes cada uno describen los siguientes hallazgos ecogr\u00e1ficos pulmonares\nen COVID-19:  &lt;2,3&gt;<\/p>\n\n<h2 class=\"wp-block-heading\">L\u00edneas B de aspecto variable, incluyendo focales, multifocales y confluentes<\/h2>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/03\/1-blines.gif\" alt=\"\" class=\"wp-image-9870\" \/><figcaption>  @giovlpicelli <em><a href=\"https:\/\/twitter.com\/giovolpicelli\/status\/1238470459680870401\">https:\/\/twitter.com\/giovolpicelli\/status\/1238470459680870401<\/a><\/em><\/figcaption><\/figure><\/div>\n\n<h2 class=\"wp-block-heading\">Consolidaciones subpleurales  <\/h2>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/03\/2-sub-pleural-consolidation.gif\" alt=\"\" class=\"wp-image-9871\" \/><figcaption>@drmarcogarrone <em>https:\/\/twitter.com\/drmarcogarrone\/status\/1236256917800050688<\/em><\/figcaption><\/figure><\/div>\n\n<h2 class=\"wp-block-heading\">Consolidaciones mayores con broncograma a\u00e9reo ocasional<\/h2>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/03\/3-large-consolidation.gif\" alt=\"\" class=\"wp-image-9872\" width=\"580\" height=\"386\" \/><figcaption>@PARADicmSHIFT: <a style=\"font-style: italic\" href=\"https:\/\/twitter.com\/PARADicmSHIFT\/status\/1238357156463869953\">https:\/\/twitter.com\/PARADicmSHIFT\/status\/1238357156463869953<\/a><\/figcaption><\/figure><\/div>\n\n<h2 class=\"wp-block-heading\">Engrosamiento pleural e irregularidad de la l\u00ednea pleural  <\/h2>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/03\/4-pleural-thickening.gif\" alt=\"\" class=\"wp-image-9873\" \/><figcaption>@yaletung <em><a href=\"https:\/\/twitter.com\/yaletung\/status\/1238059289094295552\">https:\/\/twitter.com\/yaletung\/status\/1238059289094295552<\/a><\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">Es frecuente una distribuci\u00f3n multilobar de las anomal\u00edas. Las l\u00edneas B de la ecograf\u00eda\ncorresponden a las t\u00edpicas opacidades en vidrio deslustrado visualizadas en la TC\n. Los derrames pleurales (aparte de los peque\u00f1os derrames localizados) son poco frecuentes.\nLas anomal\u00edas se visualizan con mayor frecuencia en los campos pulmonares posterior e inferior\n.  <\/p>\n\n<p class=\"wp-block-paragraph\">En las primeras fases de la infecci\u00f3n, el principal hallazgo ecogr\u00e1fico son las l\u00edneas B\nfocales. A medida que la enfermedad progresa, las l\u00edneas B pueden volverse multifocales y confluentes,\ncon una mayor evoluci\u00f3n hacia consolidaciones francas. Las l\u00edneas A deben reaparecer\ndurante la convalecencia.  <\/p>\n\n<p class=\"wp-block-paragraph\">No se ha determinado la sensibilidad y especificidad de la ecograf\u00eda pulmonar para COVID-19\n. Es probable que la especificidad sea baja, dado que las l\u00edneas B pueden\nvisualizarse en cualquier proceso patol\u00f3gico que cause enfermedad pulmonar intersticial (por\nejemplo, edema pulmonar, neumonitis, neumon\u00eda v\u00edrica, fibrosis pulmonar,\nSDRA). <\/p>\n\n<p class=\"wp-block-paragraph\">Se ha sugerido que, en un paciente con insuficiencia respiratoria, una ecograf\u00eda pulmonar\nnormal deber\u00eda descartar la COVID-19. En definitiva, la ecograf\u00eda pulmonar\nproporciona un dato adicional al cuadro cl\u00ednico completo. <\/p>\n\n<p class=\"wp-block-paragraph\"><strong>Supervisi\u00f3n<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Un documento de la reuni\u00f3n del 10 de marzo del Gruppo Italiano per la\nValutazione degli interventi in Terapia Intensiva (GIVITI) describe su\nexperiencia actual con COVID-19 en pacientes de la UCI. &lt;4&gt; Desde el punto de vista de la monitorizaci\u00f3n\n, un patr\u00f3n de l\u00ednea B difusa en la ecograf\u00eda pulmonar parece responder bien\na la PEEP. Para los pacientes con consolidaci\u00f3n posterolateral e inferior, la\npronaci\u00f3n parece ser eficaz. <\/p>\n\n<p class=\"wp-block-paragraph\"><strong>Referencias<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">1. Xie X, Zhong Z, Zhao W, et al. TAC tor\u00e1cico para la neumon\u00eda t\u00edpica 2019-nCoV\n: Relaci\u00f3n con las Pruebas RT-PCR Negativas. <em>Radiology<\/em>\n2020;200343. doi:10.1148\/radiol.2020200343.  <\/p>\n\n<p class=\"wp-block-paragraph\">2. Huang Y, Wang S, Liu Y, et al. Estudio preliminar sobre las manifestaciones ultras\u00f3nicas\nde las lesiones peripulmonares de la neumon\u00eda no cr\u00edtica por el nuevo coronavirus\n(COVID-19). <em>SSRN<\/em> 2020. doi:10.2139\/ssrn.3544750.  <\/p>\n\n<p class=\"wp-block-paragraph\">3. Peng Q, Wang X, Zhang L. Hallazgos de la ecograf\u00eda pulmonar de la nueva neumon\u00eda por virus corona\ndurante la epidemia de 2019-2020. <em>Intensive Care Med<\/em>\n2020. doi:10.1007\/s00134-020-05996-6. <\/p>\n\n<p class=\"wp-block-paragraph\">4. Gruppo italiano per la Valutazione degli interventi in Terapia\nIntensiva (GIVITI). COVID Pacientes de UCI &#8211; Experiencia italiana. 3 de marzo de 2020.\nDisponible en:<a href=\"https:\/\/www.dropbox.com\/s\/r2ca63ckaimp1f6\/COVID%20ITU%20Patients%20Italian%20Experience.docx?dl=0\"> https:\/\/www.dropbox.com\/s\/r2ca63ckaimp1f6\/COVID%20ITU%20Patients%20Italian%20Experience.docx?dl=0<\/a>  <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Daniel J. Kim, MD FRCPC El Dr. Kim es m\u00e9dico de urgencias en Vancouver. Para ayudar a los usuarios de Clarius a comprender c\u00f3mo pueden utilizar la ecograf\u00eda en el cribado y seguimiento de la COVID-19, pedimos al Dr. Kim que elaborara un art\u00edculo resumiendo las mejores pr\u00e1cticas actuales. Clarius compartir\u00e1 actualizaciones sobre el uso&#8230;<\/p>\n","protected":false},"author":4,"featured_media":33615,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","inline_featured_image":false,"footnotes":""},"categories":[146,144],"tags":[],"specialities":[130,54],"class_list":["post-152934","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-education","category-news","specialities-critical-care","specialities-emergency-medicine"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.6 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Utilidad cl\u00ednica y t\u00e9cnica de la ecograf\u00eda pulmonar en casos de COVID-19 | Clarius | Blog Post<\/title>\n<meta name=\"description\" content=\"Daniel J. 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