Diagnostic performance of 6-point Lung ultrasound in ICU patients: Comparison with Chest X-Ray & CT thorax [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-73603

Diagnostic performance of 6-point Lung ultrasound in ICU patients: Comparison with Chest X-Ray & CT thorax

Mohammad Danish1, Aarti Agarwal1, Puneet Goyal1, Devendra Gupta1, Hira Lal2, Raghunandan Prasad2, Sanjay Dhiraaj1, Anil Agarwal1, Prabhaker Mishra3
1Dept of Anaesthesiology & Intensive Care, Sanjay Gandhi Post Graduate Institute Of Medical Sciences, Lucknow, UP, India
2Dept of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute Of Medical Sciences, Lucknow, UP, India
3Dept of Biostatistics & Health Informatics, Sanjay Gandhi Post Graduate Institute Of Medical Sciences, Lucknow, UP, India

Objective: To evaluate the diagnostic performance of a rapid bedside 6-point lung ultrasonography (LUS) performed by ICU physician for detection of 4 common pathological conditions of lung; alveolar consolidation, pleural effusion, interstitial syndrome and pneumothorax in critically ill patients and its comparison with bedside chest X-ray (CXR) and high resolution computerized tomographic scan (CT) of thorax. Volume of pleural effusion measured by LUS and CT thorax was also compared.
Methods: It was a cross-sectional, observational study of 90 adult patients with acute lung injury score of ≥1 admitted to medical-surgical ICU. They were examined by CXR and 6 point LUS as per BLUE protocol at bedside, followed by CT thorax in radiology department.
Results: Sensitivity of 6-point LUS for detecting alveolar consolidation, pleural effusion, interstitial syndrome and pneumothorax was 76%, 88%, 83% and 89% respectively, which was remarkably higher than CXR. Specificity of LUS was 100% for all pathologies which was again notably higher than CXR except for interstitial syndrome for which it was 88.5%. Measurement of volume of pleural effusion by LUS was comparable and had strong absolute agreement with CT thorax.
Conclusion: 6-point LUS can be a useful diagnostic tool, better than CXR in diagnosing respiratory pathologies in critically ill patients. Because of comparable diagnostic performance of LUS and CT scan and with increasing evidence in favour of LUS, requirement of CT thorax can be reduced. Radiation hazards associated with CXR and CT as well as potentially risky transfer of patients to CT room can also be minimised.

Keywords: Lung ultrasound, 6 point BLUE Protocol, Point of care ultrasound, Chest X-ray, CT Scan thorax.


Diagnostic performance of 6-point Lung ultrasound in ICU patients: Comparison with Chest X-Ray & CT thorax

Mohammad Danish1, Aarti Agarwal1, Puneet Goyal1, Devendra Gupta1, Hira Lal2, Raghunandan Prasad2, Sanjay Dhiraaj1, Anil Agarwal1, Prabhaker Mishra3
1Dept of Anaesthesiology & Intensive Care, Sanjay Gandhi Post Graduate Institute Of Medical Sciences, Lucknow, UP, India
2Dept of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute Of Medical Sciences, Lucknow, UP, India
3Dept of Biostatistics & Health Informatics, Sanjay Gandhi Post Graduate Institute Of Medical Sciences, Lucknow, UP, India

Amaç: To evaluate the diagnostic performance of a rapid bedside 6-point lung ultrasonography (LUS) performed by ICU physician for detection of 4 common pathological conditions of lung; alveolar consolidation, pleural effusion, interstitial syndrome and pneumothorax in critically ill patients and its comparison with bedside chest X-ray (CXR) and high resolution computerized tomographic scan (CT) of thorax. Volume of pleural effusion measured by LUS and CT thorax was also compared.
Yöntemler: It was a cross-sectional, observational study of 90 adult patients with acute lung injury score of ≥1 admitted to medical-surgical ICU. They were examined by CXR and 6 point LUS as per BLUE protocol at bedside, followed by CT thorax in radiology department.
Bulgular: Sensitivity of 6-point LUS for detecting alveolar consolidation, pleural effusion, interstitial syndrome and pneumothorax was 76%, 88%, 83% and 89% respectively, which was remarkably higher than CXR. Specificity of LUS was 100% for all pathologies which was again notably higher than CXR except for interstitial syndrome for which it was 88.5%. Measurement of volume of pleural effusion by LUS was comparable and had strong absolute agreement with CT thorax.
Sonuç: 6-point LUS can be a useful diagnostic tool, better than CXR in diagnosing respiratory pathologies in critically ill patients. Because of comparable diagnostic performance of LUS and CT scan and with increasing evidence in favour of LUS, requirement of CT thorax can be reduced. Radiation hazards associated with CXR and CT as well as potentially risky transfer of patients to CT room can also be minimised.

Anahtar Kelimeler: Lung ultrasound, BLUE Protocol, Point of care ultrasound, Chest X-ray, CT Scan thorax.




Corresponding Author: Aarti Agarwal, India


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