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Background: Although conventional chest radiography remains the first routine radiologic examination in mechanically ventilated patients, chest ultrasound provides more accurate information, with less ionizing radiation and less time delay.
Objective: To compare between sensitivity of chest ultrasound and routine daily chest X-ray in diagnosis and...
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Context 1
... 3 shows that there was a statistically significant cor- relation between follow-up chest ultrasound findings and the clinical changes in cases with lung consolidation and pleural effusion, while there was no significant correlation in cases with lung collapse. Table 4 shows that there was statistically significant corre- lation between follow-up chest X-ray findings and the clinical Figure 1 Mindray DP 1100 ultrasound machine. changes in cases with lung consolidation, while there was no significant correlation in cases with lung collapse and pleural effusion. ...
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Background The term ventilator-acquired pneumonia (VAP) refers to pneumonia that develops 48–72 h after endotracheal intubation. The accuracy of diagnosis is improved by combining clinical, laboratory, and radiographic criteria.
Purpose This article offers an evidence for the role of chest ultrasound in early detection of VAP and its effect on the...
Objective To describe acute kidney injury prevalence in young adults diagnosed with COVID-19 admitted to the Intensive Care Unit. Methods This is a retrospective, quantitative and analytical study. The sample consisted of young adults (20 to 40 years old) admitted to Intensive Care Units, diagnosed with SARS-CoV-2 infection between March and Decemb...
Citations
... In Rwanda, PoCUS improved diagnostic accuracy in over 50% of dyspneic patients and identified pneumonia and ADHF as the most frequent diagnoses [22] . Studies comparing LUS and CXR have produced variable findings [23][24][25] . However, agreement between LUS and final diagnosis was high compared to CXR and final diagnosis [ 10 , 26 , 27 ]. ...
... Chest radiography performed better in identifying lung collapse contrary to previous reports (25), similarly explained by "misclassification " as consolidation since they appear similar on LUS. Lobar collapse was more readily identified on CXR using lung volume loss and lack of air bronchograms. ...
Background:
Hypoxia is a common presentation in the Emergency Department (ED) worldwide. It affects 9-12% of hospitalized adults in Sub-Saharan Africa. Timely diagnosis of the multiple causes such as pneumonia, heart failure among others is challenging. Chest X-Ray (CXR), one of the most utilized imaging modalities has many limitations, and the gold standard (Computed Tomography scan) is inaccessible. Point of care ultrasound (PoCUS) is more available and increasingly being used, however little is known of its performance in resource limited EDs. The study aimed to assess the diagnostic performance of PoCUS compared with CXR in identifying the causes of hypoxia in the medical ED.
Methods:
49 adults presenting with hypoxia (SP02 ≤ 88%) in the medical ED were evaluated. Ultrasound of the lungs and heart (PoCUS) was done, then CXR obtained. Lung ultrasound (LUS) was compared with CXR (first reference standard). Chest X-Ray and PoCUS were each compared to the physician diagnosis (second reference standard) to determine agreement using an acceptable disagreement cut-off of 15%.
Results:
31% more abnormalities were identified by LUS than CXR. Lung ultrasound findings agreed with CXR in 86% of the participants with moderate reliability (ĸ=0.75). There was no significant difference between the actual findings of the two tests (X2= 2, p 0.1). Using the second reference, 82% of the CXRs were similar with weak reliability (ĸ=0.5) compared to 98% of PoCUS findings with strong reliability (ĸ=0.9). Compared to PoCUS, CXRs significantly differed from the physician diagnosis (X2= 0.85, p 0.38 vs X2= 8.5, p 0.004 respectively).
Conclusion:
Overall, PoCUS was not inferior to CXR when compared to final physician diagnosis in identifying causes of hypoxia, and LUS and CXR had comparable performance. Significantly more abnormalities were identified on PoCUS and it demonstrated better agreement and strong reliability with the physician diagnosis than CXR. We recommend PoCUS use in patients with hypoxia attending resource limited in- and pre-hospital settings.
... LUS and chest radiograph had similar sensitivity in detecting subpleural consolidation. Good concordance between chest radiograph and LUS was concluded by Khalil et al. [41]. Reissig et al. [42] in his publication described LUS as a sensitive modality for diagnosis and follow-up of community-acquired pneumonia and parapneumonic effusion. ...
... Moreover, pleural effusion was detected as a nonspecific association with RDS [29]. The superiority of LUS in detecting minimal pleural effusion is previously appreciated [41]. The direct intercostal approach generates specific standardized signs (quad and sinusoidal signs). ...
... It is noted that there was a trend toward more and earlier detection of pleural effusion by LUS than chest radiography. Similar finding was documented before by Khalil et al. [41] in a study on mechanically ventilated adults where LUS showed superiority in detection of pleural effusion at the initial diagnosis and throughout their daily follow-up of the cases. On the contrary, chest radiography was an earlier detector of new findings, particularly, lung consolidation, than LUS. ...
... Bercak infiltrat pada foto thorax juga memberikan gambaran hepatisasi yang diikuti dengan elemen hyperechoic linier pada pemeriksaan ultrasonografi paru, hai ini sejalan dengan penelitian yang dilakukan oleh Elmahalawy dkk 2017, Khalil M 2015, Blavis M 2012, De Luca 2008, Parlamento S, 2018 dimana gambaran hepatisasi paru disertai air bronchogram sign yang terlihat sebagai elemen hyperechoic linier. 11,12,13,14 Tidak ditemukan kemaknan yang signifikan pada gambaran bercak infiltrat pada foto thorax dengan lesi anechoic dan B line patologis pada ultrasonografi paru dengan besar koefisien masing-masing 0.230 dan 0.197 dengan p value > 0.05 yaitu sebesar 0.089 dan 0.186 demikian halnya dengan gambaran GGO pada foto thorax dengan gambaran hepatisasi dan elemen hyperechoic linier pada ultrasonografi paru tidak menunjukkan kemaknaan yang signifikan, nilai koefisien masing-masing sebesar 0108 dan 0. 495 dengan p value > 0.05 yaitu 0.258 dan 0.605. ...
... Penelitian serupa juga dilakukan oleh Amatya Y dkk 2018, Tichinesi A dkk 2016, Long L dkk 2017, Ye X dkk 2015, Khalil M 2015, dan Boechier dkk 2018 menunjukkan bahwa ultasonografi paru dapat digunakan dalam mendiagnosis suatu pneumonia. 9,10,12,18,19,20,21 ...
Pendahuluan Pneumonia menjadi penyebab utama kematian pada anak di bawah usia 5 tahun selama beberapa dekade. Foto X-ray dada adalah modalitas diagnostik yang paling umum digunakan. Namun, karena efek radiasi sinar-X, ultrasonografi menjadi semakin populer untuk diagnosis pneumonia pada anak-anak. Penelitian ini bertujuan untuk membandingkan dan menilai kesesuaian (agreement) antara hasil pemeriksaan x-ray dada dan ultrasonografi untuk diagnosis pneumonia pada anak-anak. Metode: Penelitian ini dilakukan di Bagian Radiologi Rumah Sakit Umum Pusat Dr. Wahidin Sudirohusodo Makassar dan Rumah Sakit Pendidikan Universitas Hasanuddin Makassar dari bulan Februari sampai April 2020. Jumlah sampel sebanyak 44 pasien berusia antara 1 hari sampai kurang dari 18 tahun. Tes Kappa digunakan untuk menilai kesesuaian antara kedua metode. Hasil: Hasil penelitian menunjukkan bahwa gambaran pneumonia pada anak berdasarkan hepatisasi pada USG paru menunjukkan kesesuaian yang signifikan dengan tanda konsolidasi pada foto thorax (koefisien Kappa = 0,560, p <0,05). Elemen hyperechoic linier pada ultrasonografi paru dengan tanda air bronchogram dan infiltrat pada foto toraks juga menunjukkan kesesuaian yang baik (koefisien Kappa = 0,596, p <0,05). Selain itu, tanda lesi anechoic pada ultrasonografi paru dengan gambar ground glass opacity (GGO) pada radiografi dada menghasilkan koefisien Kappa 0,495 dan p <0,05. Kesimpulan: Pneumonia pediatrik dimanifestasikan pada ultrasonografi sebagai hepatisasi, hyperechoic linear elements, dan pathologic B-line, sedangkan pada rontgen dada dimanifestasikan sebagai konsolidasi dan infiltrat. Kesepakatan yang baik ditemukan antara konsolidasi x-ray dengan hepatisasi pada ultrasonografi, antara elemen hyperechoic linier pada ultrasonografi dengan infiltrat pada x-ray, serta antara lesi anechoic pada ultrasonografi dengan GGO pada rontgen dada
... diffuse parenchymal lung infection) or may act as a guide for the following diagnostic or therapeutic options [e.g. computed tomography (CT), bronchoscopy, or thoracentesis] [11]. Rather than CT, chest US is non-invasive and does not utilize radiation and contrast materials. ...
... Rather than CT, chest US is non-invasive and does not utilize radiation and contrast materials. At long last, portable US permits patient assessment at bed side and can be repeated when needed without significant side effects [11]. ...
Background: Application of chest radiography for all patients with chest diseases is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department in case of emergency. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the work is to determine sensitivity, specificity and diagnostic accuracy of chest ultrasonography as an easy and fast form of imagery for different thoracic conditions. Results: This prospective study was carried out on sixty patients. The majority of patients presented with lung masses (20%) and pleural effusion (16.7%). Chest US findings showed great concordance or agreement with the chest CT findings. The only lower concordance is noted in the diagnosis of pulmonary nodules or mass, where chest US reported pulmonary nodules or mass in 33.3% of patients compared to 46.7%% by chest CT. US showed a highly comparable diagnostic performance in chest-related pathological entities, compared to chest CT. Chest US had 100% sensitivity in detecting all pathological chest entities except for lung collapse (83.3%) and pulmonary nodules (71.4%). However, chest US was more specific than sensitive. It had 100% specificity in all pathological entities except for lung collapse consolidation. Chest US had 100% diagnostic accuracy in all chest-related pathological entities except for lung collapse consolidation and pulmonary nodules or masses. However, when presenting these findings among male and female patients, Chest US had better overall diagnostic accuracy among female patients than male patients. Conclusion: US examination of the chest is a noninvasive and promising bedside tool for the examination of respiratory problems patients. Consequently, chest ultrasonography can be adjoined in the up-to-date work-up of the outpatients as an ancillary tool aiding in disease diagnosis.
... Despite lung CT is the gold standard for chest radiology, decision to perform the test must be balanced against the risk of patient transfer and the high radiation exposure. CT is mostly considered when inherent limitations of CXR result in unclear diagnosis (4,12) . Consequently, chest X ray was used for screening, diagnosis and follow up of pulmonary complications in critically ill patients especially if attached to ventilator (5) . ...
... In addition to the above clinical conditions, LUS was employed and compared to CXR for the assessment of pneumothorax, pulmonary edema, and ARDS (12,15,(27)(28)(29) . Based on the high efficacy of LUS in the diagnosis of pneumothorax, the Eastern Association for the Surgery of Trauma gave a level 2 recommendation for the use of ultrasound to identify traumatic pneumothorax in its practice management guidelines (30) . ...
... In our study, there was a significant agreement between chest ultrasound and chest radiographic findings in most cases regarding pleural effusion, with 96% agreement (the majority of cases with pleural effusion can be detected with both of them except two cases detected by chest ultrasound only with 100% sensitivity and 95% specificity). The study conducted by Khalil et al. [29] on 25 mechanically ventilated patients found that chest ultrasound had higher sensitivity than chest radiography in the detection of pleural effusion. Moreover, the study conducted by Elnaem et al. [30] on 90 adult critically ill patients found that chest radiography can detect pleural effusion with 63.0% sensitivity and 96.8% specificity, whereas chest ultrasound can detect pleural effusion with 92.6% sensitivity and 100.0% ...
Context Chest ultrasound has a complementary role in patients with pulmonary tuberculosis (PTB). It can detect lesion especially in pleural and subpleural area.
Aim To assess chest ultrasound findings in patients with PTB with and without HIV.
Settings and design This was a prospective comparative cross-sectional study that was conducted in Abbassia Chest Hospital from November 2017 to November 2018.
Patients and methods The study was conducted on 50 new patients with PTB sputum positive by acid-fast bacilli or genexpert. They were classified into two groups: group I, with 25 HIV-negative patients, group II, with 25 HIV-positive patients. All patients underwent routine laboratory investigations, chest radiography, and chest and abdominal ultrasound.
Statistical analysis The analysis of comparison between the two groups regarding chest ultrasound findings was done using SPSS statistical package.
Results There was no significant difference between the two groups regarding chest ultrasound findings. The most frequent finding was subpleural nodules. It is present in all patients. Shred sign was present in 84% of both groups. Subpleural consolidation was present in all patients in group I and 88% of group II. Pleural effusion was present in 20% of group I and 28% of group II. Stratosphere sign and lung point were present in 8% of group II. Cavitation was present in 8% of group I. In both groups, A profile was present in 12%, B profile in 44%, and AB profile in 44%.
Conclusion There was no significant difference between patients with PTB with and without HIV regarding chest ultrasound findings. Chest ultrasound is a complementary tool in patients with TB with and without HIV.
... TS has turned into an undeniably profitable demonstrative apparatus in different chest diseases [2]. Its effect on the diagnosis and management has been established in several studies [3,4], particularly under crisis conditions by utilizing TS, a few conditions might be quickly diagnosed (e.g. pneumonia, pulmonary embolism, pleural, and in addition pericardial effusion, pneumothorax, and atelectasis), or even might be suspected (e.g. ...
Abstract Background Diverse imaging systems can be utilized for the evaluation of chest issues in ICU patients; ultrasound (US) is a decent analytic instrument without exposing the patients to radiation and risk of transfer. Objectives To compare the diagnostic performance of transthoracic US and bedside chest radiography (CXR) for the detection of various pathological abnormalities in fundamentally sick patients, using chest computed tomography as a gold standard. Patients and methods Two hundred and fifty-six patients who were admitted in the Respiratory Care Unit were included in this study. CXR, computed tomography, and transthoracic US were done to all the patients. Six pathological entities were evaluated: pleural effusion, pneumothorax, consolidation, interstitial lung diseases, pulmonary embolism, and neoplasms. Results All patients were evaluated by the three imaging techniques. The sensitivity and specificity of CXR were 42.1, 84.4% for pneumonia 50.0, 90.0% for pleural effusion, 45.5, 90.6% for interstitial syndrome, 50.0, 94.8% for pneumothorax, 60, 100% for pulmonary embolism, and 66, 94% for neoplasm, while the values for chest US were 89.47, 100% for pneumonia, 60, 100% for pulmonary embolism, 100, 100% for pleural effusion, pneumothorax, interstitial syndrome, and neoplasm. Conclusion US examination of the chest is a noninvasive and promising bedside tool in the evaluation of patients in the Respiratory Care Unit.
... TS has turned into an undeniably profitable demonstrative apparatus in different chest diseases [2]. Its effect on the diagnosis and management has been established in several studies [3,4], particularly under crisis conditions by utilizing TS, a few conditions might be quickly diagnosed (e.g. pneumonia, pulmonary embolism, pleural, and in addition pericardial effusion, pneumothorax, and atelectasis), or even might be suspected (e.g. ...
Background Diverse imaging systems can be utilized for the evaluation of chest issues in ICU patients; ultrasound (US) is a decent analytic instrument without exposing the patients to radiation and risk of transfer. Objectives To compare the diagnostic performance of transthoracic US and bedside chest radiography (CXR) for the detection of various pathological abnormalities in fundamentally sick patients, using chest computed tomography as a gold standard. Patients and methods Two hundred and fifty-six patients who were admitted in the Respiratory Care Unit were included in this study. CXR, computed tomography, and transthoracic US were done to all the patients. Six pathological entities were evaluated: pleural effusion, pneumothorax, consolidation, interstitial lung diseases, pulmonary embolism, and neoplasms. Results All patients were evaluated by the three imaging techniques. The sensitivity and specificity of CXR were 42.1, 84.4% for pneumonia 50.0, 90.0% for pleural effusion, 45.5, 90.6% for interstitial syndrome, 50.0, 94.8% for pneumothorax, 60, 100% for pulmonary embolism, and 66, 94% for neoplasm, while the values for chest US were 89.47, 100% for pneumonia, 60, 100% for pulmonary embolism, 100, 100% for pleural effusion, pneumothorax, interstitial syndrome, and neoplasm. Conclusion US examination of the chest is a noninvasive and promising bedside tool in the evaluation of patients in the Respiratory Care Unit. Egypt J Bronchol 2019 13:323-327
... Lung US has been recently introduced in our respiratory ICU (RICU). Its effect on diagnosis and management has been established in several studies [9,10]. Combing lung US examination with other organ US examinations, such as heart, inferior vena cava (IVC), abdomen, and deep venous system, using POCUS concept into standard diagnostic assessment of critical ICU patients, remains scarcely applied on the international level and has never been applied in our RICU [11,12]. ...
... At bedside, initial chest ultrasound is more sensitive than chest radiographies in the detection of small pleural effusions that are misdiagnosed as parenchymal opacities or are not seen [9,30]. A total of 32 pleural effusions were detected in our study (Fig. 2), and with the help of bedside LUS, the nature of the fluid could be assessed and aided the change in the management in three cases. ...
Abstract Background Implementing point-of-care multiorgan ultrasound (POCUS) to the initial assessment of ICU patients allows intensivists to immediately integrate ultrasound findings with the patient history, physical, and laboratory results, yielding a powerful clinical synergy, improving diagnostic accuracy, and ameliorating further management plans. The aim of this work was to assess the diagnostic performance and therapeutic effect of POCUS in patients admitted to respiratory ICU (RICU). Patients and methods A prospective study was carried out on patients admitted to the RICU. POCUS examination was performed to the patients within 12 h of admission that included echocardiography, lung ultrasound, abdominal ultrasound including inferior vena cava assessment and lower limb venous duplex. Results A total of 102 patients were included. The total number of sonographic findings was 320, of which 94 (29.3%) were new findings. This resulted in confirmation of the admitting diagnosis, modification of the admitting diagnosis, prompted further testing, change in medical therapy prescribed, and prompted invasive procedures in 35, 51, 11, 41, and 14% of patients, respectively. However, it was ineffective in confirming or modifying diagnosis, provided wrong diagnosis, and missed a diagnosis in 29.4, 2, and 11.7% of patients, respectively. Conclusion Integrating POCUS in the initial assessment of critically ill RICU patients together with standard diagnostic tests lead to diagnostic and therapeutic changes in most of patients which affected the management of these patients. Thus, it seems reasonable to consider the routine use of POCUS as a new respiratory examination option in the armamentarium of the intensivists.
... Lung US has been recently introduced in our respiratory ICU (RICU). Its effect on diagnosis and management has been established in several studies [9,10]. Combing lung US examination with other organ US examinations, such as heart, inferior vena cava (IVC), abdomen, and deep venous system, using POCUS concept into standard diagnostic assessment of critical ICU patients, remains scarcely applied on the international level and has never been applied in our RICU [11,12]. ...
... At bedside, initial chest ultrasound is more sensitive than chest radiographies in the detection of small pleural effusions that are misdiagnosed as parenchymal opacities or are not seen [9,30]. A total of 32 pleural effusions were detected in our study (Fig. 2), and with the help of bedside LUS, the nature of the fluid could be assessed and aided the change in the management in three cases. ...
