The Diagnostic Role of Lung Ultrasound in Critically Ill Patients In Comparison With Chest X-Ray

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mina Fayez Hanna ◽  
Fahmy Saad Latef ◽  
Ahmed Mohamed El-Sayed El-Hennawy ◽  
Wessam Zaher Selima
Keyword(s):  
Pleural Effusion ◽  
Critically Ill ◽  
Sensitivity And Specificity ◽  
Critically Ill Patients ◽  
Lung Ultrasound ◽  
Low Cost ◽  
Acute Dyspnea ◽  
X Ray ◽  
Pleural Diseases ◽  
Chest X Ray

Abstract Purpose To compare between lung ultrasound and chest X-ray in diagnosis of different lung pathologies in critically ill patients using lung CT as a gold standard. Methods Comparative prospective randomized single group observational study was conducted in the Critical Care unit (medical and surgical ICU). The study was conducted upon fifty patients (28 females &22 males) with a mean age of 58 years (SD ± 15.55; (19 - 82) presented to Kom Hamadah Hospital during a period of one year starting from July 2018 to July 2019, with acute dyspnea as the primary complaint or developed acute dyspnea and or tachypnea during their ICU stay were evaluated for the presence of pleural effusion, pneumothorax, alveolar-Interstitial Pathology and consolidation by LUS and CXR for detecting the sensitivity and specificity of each modality with CT chest done as a reference in cases of doubt. Results The comparison between Sensitivity and Specificity of US finding was (86.8% for parenchymal disease, 100.0% for pleural diseases) and (100.0% for parenchymal diseases, 94.7% for pleural diseases) respectively while CXR finding was (65.8% for parenchymal diseases, 75.0% for pleural diseases) and (58.3% for parenchymal diseases), (92.1% for pleural diseases) respectively among studied patients. Conclusion Transthoracic ultrasound is valuable for the evaluation of a wide variety of chest diseases, particularly mechanically ventilated patient. The advantages of low cost, bedside availability and no radiation exposure have made ultrasound an indispensable diagnostic tool in ICU. Lung ultrasound is more sensitive than chest x-ray in diagnosis and follow up chest diseases) PNX, alveolar-interstitial syndromes, parenchymal consolidations, and pleural effusion (LUS is an interesting medical method that is complementary to bedside CXR and reduces the need to use a CT scan.

Evaluation Of The Role Of Bedside Lung Ultrasound Versus Chest X-ray In Critically Ill Patients

2019 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Nermeen Ali ◽  
Hassan Maguid ◽  
Neven Gamil ◽  
Mohamed Tawfeek ◽  
Sameh Hegab
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Lung Ultrasound ◽  
X Ray ◽  
Chest X Ray

scholarly journals Lung Ultrasound in COVID-19 pandemic: Why? How? And When?

2020 ◽  
pp. 3-12
Author(s):  
Khrystyna Pronyuk ◽  
Andriy Vysotskyi
Keyword(s):  
Critically Ill ◽  
Computer Tomography ◽  
Critically Ill Patients ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Clinical Decision ◽  
X Rays ◽  
Lung Involvement ◽  
X Ray ◽  
Chest X Ray

During COVID-19 pandemic Lung ultrasound has rapidly become a tool for diagnosis and monitoring of lung involvement and it’s severity. Accurate evaluation of lung pathologic entities at the bedside, especially in critically ill patients, and those on mechanical ventilation, remains problematic. CT should not be frequently repeated and is not available everywhere, especially for critically ill patients. Limitations of bedside chest X-ray have been well described and lead to poor-quality X-ray films with low sensitivity.The lung ultrasound has been shown to be a useful tool in intensive care patients with adult respiratory distress syndrome (ARDS) and can be used forassessing severity of lung involvement in COVID-19. In this paper the accuracy of bedside LUS, chest X-ray and computer tomography are compared based on clinical cases, typical for COVID-19 lung ultrasound appearance is evaluated. There have been shown that lung ultrasound can predict the deterioration of the patient's conditionand can be used for risk stratification and clinical decision making, reducethe use of both chest x‐rays and computer tomography, what is very important especially in limited resources settings.

scholarly journals Lung Ultrasonography and Chest Radiography in Suspected Cases of Pneumonia in Critically Ill Patients- A Comparative Study

2020 ◽  
Vol 8 (2) ◽  
pp. 88-90
Author(s):  
Bharat M.P ◽  
Deepak K.S
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Chest Radiography ◽  
Lung Ultrasound ◽  
Age Group ◽  
Lung Ultrasonography ◽  
Predictive Values ◽  
X Ray ◽  
Chest X Ray ◽  
The Difference

Background: The present study compared lung ultrasound (USG) and chest radiography in suspected cases of pneumonia in critically ill patients. Subjects & Methods: 56 patients age above 20 years of age of both genders diagnosed with pneumonia were included. Patients were subjected to chest USG and X ray. Positive predictive values for both lung ultrasound and chest X-ray were calculated. Results: Age group 20-30 years had 4 patients, 30-40 years had 6, 40-50years had 10, 50-60 years had 16 and >60 years had 20 patients. The difference was significant (P< 0.05). Chest x ray reveled 40 out of 56 cases positive and 16 negative and USH showed 52 positive and 4 negative. Positive predictive value (PPV) of chest x- ray was 71.4% and USG was 92.8%. The difference was significant (P< 0.05). Conclusion: Lung ultrasound is an effective radiological tool for the assessment of suspected cases of pneumonia as compared to chest x ray.

scholarly journals EVALUATION OF THE ROLE OF BEDSIDE LUNG ULTRASOUND VERSUS CHEST X-RAY IN CRITICALLY ILL PATIENTS

2019 ◽  
Vol 25 (6) ◽  
pp. 887-897
Author(s):  
Nermeen Ali ◽  
Hassan Maguid ◽  
Neven Gamil ◽  
Mohamed Tawfeek ◽  
Sameh Hegab
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Lung Ultrasound ◽  
X Ray ◽  
Chest X Ray

scholarly journals Chest-X-ray is a mainstay for follow-up in critically ill patients with covid-19 induced pneumonia

2020 ◽  
Vol 129 ◽  
pp. 109075 ◽  
Author(s):  
Olivier de Barry ◽  
Ilan Obadia ◽  
Mostafa El Hajjam ◽  
Robert-Yves Carlier
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
X Ray ◽  
Chest X Ray

Lung Ultrasound versus Chest X-Ray for the Detection of Fluid Overload in Critically Ill Children: A Systematic Review

2021 ◽  
Author(s):  
Emily Schapka ◽  
Jerica Gee ◽  
John W. Cyrus ◽  
Gregory Goldstein ◽  
Kara Greenfield ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Lung Ultrasound ◽  
Fluid Overload ◽  
Volume Overload ◽  
High Sensitivity ◽  
Critically Ill Children ◽  
Eligibility Criteria ◽  
X Ray ◽  
Chest X Ray

AbstractFluid overload is a common complication of critical illness, associated with increased morbidity and mortality. Pulmonary fluid status is difficult to evaluate clinically and many clinicians utilize chest X-ray (CXR) to identify fluid overload. Adult data have shown lung ultrasound (LUS) to be a more sensitive modality. Our objective was to determine the performance of LUS for detecting fluid overload, with comparison to CXR, in critically ill children. We conducted a systematic review using multiple electronic databases and included studies from inception to November 15, 2020. The sensitivity and specificity of each test were evaluated. Out of 1,209 studies screened, 4 met eligibility criteria. Overall, CXR is reported to have low sensitivity (44–58%) and moderate specificity (52–94%) to detect fluid overload, while LUS is reported to have high sensitivity (90–100%) and specificity (94–100%). Overall, the quality of evidence was moderate, and the gold standard was different in each study. Our systematic review suggests LUS is more sensitive and specific than CXR to identify pulmonary fluid overload in critically ill children. Considering the clinical burden of fluid overload and the relative ease of obtaining LUS, further evaluation of LUS to diagnose volume overload is warranted.

scholarly journals Diagnosis Accuracy of Lung Ultrasound for ARF in Critically Ill Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Xueyan Yuan ◽  
Ling Liu ◽  
Wei Chang ◽  
Zongsheng Wu ◽  
Lili Huang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Sensitivity And Specificity ◽  
Critically Ill Patients ◽  
Lung Ultrasound ◽  
Early Recognition ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Cochrane Library ◽  
Bivariate Model

Background: Acute respiratory failure (ARF) is a commonly distressing condition in critically ill patients. Its early recognition and treatment may improve clinical outcomes. Mounting evidence suggests that lung ultrasound (LUS) could be an alternative to chest X-ray (CXR) or computed tomography (CT) for the diagnosis of ARF in critically ill patients. This meta-analysis aimed to determine whether LUS can be an alternative tool used to investigate the cause of ARF or thoracic pathologies associated with the diagnosis of ARF in critically ill patients.Method: A systematic literature search of the PubMed, Web of Science, Embase, and Cochrane Library databases was conducted from inception to March 2020. Two researchers independently screened studies investigating the accuracy of LUS with CXR or CT for adult critically ill patients with ARF. Data with baseline, true positives, false positives, false negatives, and true negatives were extracted. The study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The pooled sensitivity and specificity were obtained using a bivariate model.Results: Eleven studies, including 1,232 patients, were included in the meta-analysis. Most studies were of low quality. LUS had a pooled sensitivity of 92% (95% confidence interval [CI]: 85–96) and a pooled specificity of 98% (95% CI: 94–99). The area under the summary receiver operating characteristic curve was 98% (95% CI: 97–99). The sensitivity and specificity of LUS to identify different pathological types of ARF were investigated. For consolidation (1,040 patients), LUS had a sensitivity of 89% and a specificity of 97%. For pleural effusion (279 patients), LUS had a pooled sensitivity of 95% and a specificity of 99%. For acute interstitial syndrome (174 patients), LUS had a pooled sensitivity of 95% and a specificity of 91%.Conclusions: LUS is an adjuvant tool that has a moderate sensitivity and high specificity for the diagnosis of ARF in critically ill patients.Systematic Review Registration: The study protocol was registered with PROSPERO (CRD42020211493).

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